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

Jon Ryan Wallis, DMD

Individual provider Dentist · NPI 1821510728

Jon Ryan Wallis, DMD is a Dentist in Casa Grande, Arizona. Licensed in Arizona. Registered with an NPI since 2017.

Licensed in
AZ
In the registry since
2017
What do these letters mean?
DMD — Doctor of Dental Medicine
A dentist. Identical training and licensing to a DDS.

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Practice location Address checks out

2028 N Trekell Rd Ste 107
Casa Grande, AZ 85122-1326
Phone: (520) 876-9955
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence D009781 (AZ)

Record details

NPI number1821510728
Entity typeIndividual (Type 1)
GenderMale
Credentials DMD
Sole proprietorNo
NPI enumeratedJuly 12, 2017
Last updated in NPPESJuly 12, 2017
Mailing address3809 E Yeager Dr, Gilbert, AZ 85295-1613

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