Doctor profile · Federal record
Dr. Michael Wallace, DDS
Dentist · Edmond, OK
- NPI 1417014424
- 19 yrs on file
- Male
- Solo practice
- No sanctions
Practice & contact
- Primary practice
-
1617 E Danforth RD
Edmond, OK 730343103
(405) 340-0411
fax (405) 340-3217 - Mailing address
-
1617 E Danforth Road
Edmond, OK 730346622
Credentials & registration
- NPI registered
- January 2007 — 19 yrs on file
- Profile last updated
- January 28, 2021
- Specialty taxonomy
- 122300000X — NUCC code
- State license (1)
- Oklahoma #5801
- Medicaid
- OK #200066490 A
Federal sanctions & exclusions
No sanctions, exclusions or revocations on file
Checked against OIG LEIE on NPI 1417014424. Last verified May 11, 2026.Open Payments
Industry payments received
All-time total
$1,929
Transactions
11
Manufacturers
4
| Payer (manufacturer) | Industry | Txns | Amount |
|---|---|---|---|
| Patterson Companies, INC. | 1 | $750.00 | |
| Ultradent Products INC | 7 | $676.26 | |
| Dentsply Sirona INC | 2 | $489.00 | |
| Philips North America LLC | 1 | $13.92 |
By nature of payment
Medicare Part D · 2023
Top prescriptions
Total claims
55
Patients
22
Total drug cost
$1,039
| Drug | Type | Claims | Patients | Total cost |
|---|---|---|---|---|
| Amoxicillin | Generic | 29 | 22 | $74 |
| Pilocarpine Hcl | Generic | 26 | 0 | $965 |
Frequently asked questions
What is Dr. Michael Wallace's medical specialty?
Dr. Michael Wallace practices Dentist in Edmond, OK.
Where does Dr. Michael Wallace practice?
Dr. Michael Wallace practices at 1617 E Danforth RD, Edmond, OK 730343103. Office phone: 4053400411.
What is Dr. Michael Wallace's NPI?
Dr. Michael Wallace's National Provider Identifier (NPI) is 1417014424, issued by NPPES.