Stephen Wallace DDS PC
NPI 1629121561ActiveOrganization· Dentist, Periodontics· Waterbury, CT
Dentist, Periodontics in Waterbury, Connecticut, registered in NPPES in January 2007. The authorized official on file is Jennifer M. Cathcart, Office Manager.
Overview
| NPI | 1629121561 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jan 22, 2007 |
| Last updated in NPPES | Mar 22, 2012 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist, Periodontics Primary | 1223P0300X | 4383 | CT |
| Dentist, Periodontics | 1223P0300X | 044912-1 | NY |
| Dentist, Periodontics | 1223P0300X | DN11169 | MA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
Other Dentist, Periodontics providers in Waterbury
- 1710008842
- 1700954856
- 1679868822