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

Wallace Carrillo-Medina DMD PA

Organization Orofacial Pain Dentistry · NPI 1558869917

Wallace Carrillo-Medina DMD PA is an Orofacial Pain Dentistry in Asheboro, North Carolina. Licensed in North Carolina. Registered with an NPI since 2018.

Licensed in
NC
In the registry since
2018
Specialties on file
2
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

511 Greensboro St
Asheboro, NC 27203-4736
Phone: (732) 692-6929
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dental Clinic/Center (primary) Taxonomy 261QD0000X · Licence 9900 (NC)
Orofacial Pain Dentistry Taxonomy 1223X2210X

Record details

NPI number1558869917
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Wallace Carrillo-Medina — President · (336) 629-3112
NPI enumeratedJanuary 30, 2018
Last updated in NPPESFebruary 24, 2021
Certification dateFebruary 23, 2021
Mailing address511 Greensboro St, Asheboro, NC 27203-4736

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