Kevin Wallace, DMD
NPI 1053423285 · General Practice Dentistry · Chicago, IL
Enrolled with Medicare as Practitioner - Oral Surgery · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Kevin Wallace, DMD is a General Practice Dentistry provider in Chicago, IL (NPI 1053423285).
Provider details
- NPI number
- 1053423285
- Entity type
- Individual
- Primary specialty
- General Practice DentistryDental Providers
- Credential
- DMD
- Sex
- Male
- Sole proprietor
- No
- License
- 019022339 (IL)
Specialties & taxonomies
Dental Providers
Dental Providers
Dental Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure28% of score
19 yrs in NPPES registry
- Profile completeness28% of score
100% of core fields populated
- Practice footprint17% of score
1 documented practice location
- Medicare service volume (vs. specialty peers)28% of score
1,359 Medicare services, 2024 (ranked within specialty)
Medicare volume is ranked against active providers in the same specialty. Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
What this provider does (Medicare)
Based on Medicare fee-for-service claims, 2024; not all care is captured.
| Service (HCPCS) | Medicare services | Typical Medicare-allowed (2024) |
|---|---|---|
| Established Patient Office Or Other Outpatient Visit With Low Level OD Decision Making, If Using Time, 20 Minutes Or More99213 | 313 | $89 |
| Imaging of Jaws and Skull70350 | 238 | $16 |
| Ct Scan of Face Without Contrast70486 | 238 | $126 |
| X-Ray of Lower Jaws, Upper Jaws and Teeth70355 | 234 | $18 |
| New Patient Office Or Other Outpatient Visit With Straightforward Medical Decision Making, If Using Time, 15 Minutes Or More99202 | 119 | $67 |
| New Patient Office Or Other Outpatient Visit With Low Level of Medical Decision Making, If Using Time, 30 Minutes Or More99203 | 113 | $110 |
Practice location
Mailing address
Registry dates
- Enumerated
- 2006-09-01
- Last updated
- 2021-01-19
- Certified
- 2021-01-19
Frequently asked questions
- What is Kevin Wallace's NPI number?
- Kevin Wallace's National Provider Identifier (NPI) is 1053423285, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Kevin Wallace's specialty?
- Kevin Wallace is listed in the NPPES registry with a primary specialty of General Practice Dentistry (Dental Providers).
- Where is Kevin Wallace located?
- Kevin Wallace's practice location on file with NPPES is 150 E Huron St, Chicago, IL 60611.
- What is Kevin Wallace's phone number?
- The practice phone number listed in the NPPES registry for Kevin Wallace is (312) 676-9893.
- Does Kevin Wallace accept Medicare?
- Kevin Wallace is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Kevin Wallace's NPI active?
- Yes — Kevin Wallace's NPI (1053423285) is active in the NPPES registry as of the last update on 2021-01-19.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.