Ellie Wallace, DDS
NPI 1124850763ActiveIndividual· Dentist, General Practice· Cadillac, MI
Dentist, General Practice (DDS) in Cadillac, Michigan, licensed in MI, with an NPI issued in August 2024. Part D covered 37 prescriptions written in 2024, 95% of them generic.
Overview
| NPI | 1124850763 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | DDS |
| Sole proprietor | No |
| NPI issued | Aug 14, 2024 |
| Last updated in NPPES | Aug 14, 2024 |
| Certified by provider | Aug 14, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist, General Practice Primary | 1223G0001X | 2901602301 | MI |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Order and Referring Only - Dentist (MI) |
|---|
Part D prescriptions in 2024
| Prescriptions (claims) | 37 · 40 30-day fills |
|---|---|
| Patients | 29 |
| Total drug cost | $287.32 |
| Generic share | 95% of claims |
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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All 19 general dentists in Cadillac · All general dentists in Michigan