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

Phillip Wendell Wallace, DDS

Individual provider General Practice Dentistry · NPI 1083759930

Phillip Wendell Wallace, DDS is a General Practice Dentistry in Willoughby, Ohio. Practices as a sole proprietor. Licensed in Ohio.

Licensed in
OH
In the registry since
2007
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

36001 Euclid Ave Ste A15
Willoughby, OH 44094-4643
Phone: (440) 946-5484
Fax: (440) 946-5810
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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 16266 (OH)

Record details

NPI number1083759930
Entity typeIndividual (Type 1)
GenderMale
Credentials DDS
Sole proprietorYes
NPI enumeratedFebruary 20, 2007
Last updated in NPPESJuly 8, 2007
Mailing address36001 Euclid Ave Ste A15, Willoughby, OH 44094-4643

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