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

Kim Eugene Wallace, DDS

Individual provider General Practice Dentistry · NPI 1689681041

Kim Eugene Wallace, DDS is a General Practice Dentistry in Davis, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2006
What do these letters mean?
DDS — Doctor of Dental Surgery
A dentist. DDS and DMD are the same qualification — universities choose which title to award.

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Practice location Address checks out

635 Anderson Rd Ste 17
Davis, CA 95616-3505
Phone: (530) 757-6453
Fax: (530) 757-6450
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X · Licence 22932 (CA)

Record details

NPI number1689681041
Entity typeIndividual (Type 1)
GenderMale
Credentials DDS
Sole proprietorYes
NPI enumeratedAugust 1, 2006
Last updated in NPPESMay 11, 2016
Mailing address635 Anderson Rd, Suite 17, Davis, CA 95616-3505

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