Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Stephen Wallace DDS PC

Organization Periodontics · NPI 1629121561

Stephen Wallace DDS PC is a Periodontics in Waterbury, Connecticut. Licensed in Connecticut, Massachusetts and New York. Registered with an NPI since 2007.

Licensed in
CT, MA, NY
In the registry since
2007
Specialties on file
3
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

140 Grandview Ave Ste 102
Waterbury, CT 06708
Phone: (203) 753-1112
Fax: (203) 573-0773
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Periodontics (primary) Taxonomy 1223P0300X · Licence 4383 (CT)
Periodontics Taxonomy 1223P0300X · Licence 044912-1 (NY)
Periodontics Taxonomy 1223P0300X · Licence DN11169 (MA)

Record details

NPI number1629121561
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jennifer Cathcart — Office Manager · (203) 753-1112
NPI enumeratedJanuary 22, 2007
Last updated in NPPESMarch 22, 2012
Mailing address140 Grandview Ave, Suite 102, Waterbury, CT 06708

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