Mark Wallace, DDS
NPI 1104047190 · General Practice Dentistry · Saint Paul, MN
Enrolled with Medicare as Order and Referring Only - Dentist · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Mark Wallace, DDS is a General Practice Dentistry provider in Saint Paul, MN (NPI 1104047190).
Provider details
- NPI number
- 1104047190
- Entity type
- Individual
- Primary specialty
- General Practice DentistryDental Providers
- Credential
- DDS
- Sex
- Male
- Sole proprietor
- No
- License
- 5919 (WA)
Specialties & taxonomies
Dental Providers
Dental Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure33% of score
19 yrs in NPPES registry
- Profile completeness33% of score
100% of core fields populated
- Practice footprint20% of score
1 documented practice location
- Open Payments transparency13% of score
Has Open Payments disclosures (2024)
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 prescribes (Medicare Part D)
Top drugs by Medicare Part D claim volume, 2024 · 2 distinct drugs on file.
| Drug | Part D claims (2024) | Beneficiaries |
|---|---|---|
| Amoxicillin | 44 | 34 |
| Acetaminophen With Codeinebrand: Acetaminophen-Codeine | 23 | 20 |
Medicare Part D only. These counts cover prescriptions paid through Medicare Part D in 2024 — they do notinclude cash-pay, commercial-insurance, Medicaid, or Part B–administered drugs, and badly undercount high cash-pay categories (e.g. GLP-1 weight-loss, testosterone, and ED medications). Any drug with 10 or fewer claims is omitted by CMS, and beneficiary counts under 11 are suppressed — so a missing drug means no Part D record, never zero. This is a factual claims summary, not an endorsement, not medical advice, and not a consumer report. Source: CMS Medicare Part D Prescribers — by Provider and Drug.
Transparency — industry payments
Based on CMS Open Payments, 2024; not all care is captured.
$108 across 2 records (Open Payments 2024)
Open Payments discloses payments and transfers of value (meals, travel, consulting, research, royalties) from drug and device makers to providers. This is a transparency signal, not a verdict — such payments are legal and common, and their presence is neither an endorsement nor a criticism. Source: CMS Open Payments, program year 2024.
Practice location
Mailing address
Registry dates
- Enumerated
- 2007-05-01
- Last updated
- 2012-06-25
Frequently asked questions
- What is Mark Wallace's NPI number?
- Mark Wallace's National Provider Identifier (NPI) is 1104047190, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Mark Wallace's specialty?
- Mark Wallace is listed in the NPPES registry with a primary specialty of General Practice Dentistry (Dental Providers).
- Where is Mark Wallace located?
- Mark Wallace's practice location on file with NPPES is 50 County Road B E, Saint Paul, MN 55117-1927.
- What is Mark Wallace's phone number?
- The practice phone number listed in the NPPES registry for Mark Wallace is (651) 488-2541.
- Does Mark Wallace accept Medicare?
- Mark Wallace is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Mark Wallace's NPI active?
- Yes — Mark Wallace's NPI (1104047190) is active in the NPPES registry as of the last update on 2012-06-25.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.