Ryan Wallace, D.D.S

NPI 1477875458 · on the registry since 2010

Practice

Address: 12300 Wilshire Blvd Ste 400
Los Angeles, CA 90025
Phone: (310) 597-0715
Fax: (310) 458-8804
Organisation at this address: Jose Ignacio Perea Inc
Wilshire Oral Surgery & Implant Center
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 12

Registry record

Primary taxonomy: 1223P0700X
1223P0700X
Licence states on file: CA
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2025-06-12

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California