Individual provider Active NPI

David Kimball Walton, DDS, MS

  • Periodontics
  • Fort Collins, CO
National Provider Identifier
1003886995
Registry record updated Jun 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
9031 Issued in CO
Practice address
4026 S Timberline Rd Unit 120
Fort Collins, CO 80525-6024
Phone
(970) 482-2210
Fax
(970) 482-2208
NPI assigned
Jan 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 9031 CO Primary

Addresses

Primary practice location

4026 S Timberline Rd Unit 120
Fort Collins, CO 80525-6024

Mailing address

4026 S Timberline Rd Unit 120
Fort Collins, CO 80525-6024
Phone (970) 482-2210

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
9031COMDPeriodontist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1138060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340841600000",
    "number": "1003886995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4026 S TIMBERLINE RD UNIT 120",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805256024",
            "telephone_number": "970-482-2210",
            "fax_number": "970-482-2208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4026 S TIMBERLINE RD UNIT 120",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805256024",
            "telephone_number": "970-482-2210",
            "fax_number": "970-482-2208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTON",
        "first_name": "DAVID",
        "middle_name": "KIMBALL",
        "name_prefix": "Dr.",
        "credential": "DDS, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-24",
        "last_updated": "2012-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CO",
            "license": "9031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.