Ragonva Shante Walls, D.D.S

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

8059 Issued in TN

Practice address

1273 E Raines Rd
Memphis, TN 38116-5816

Phone

(901) 398-6435

NPI assigned

Jan 25, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Ragonva Shante Walls Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Networks

• MS PPO D-SNP
• TN PPO C-SNP
• KY PPO C-SNP
• MS PPO C-SNP

Interoperability endpoints

• Direct secure messaging: ragonva.walls.p2@direct.360care.nextgenshare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Whitehaven Dental Care Inc.

  • Dentist
  • Memphis, TN
  • NPI 1104367481
  NPD (past) Authorized official

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498003200000",
    "number": "1013062249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1273 E RAINES RD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381165816",
            "telephone_number": "901-398-6435",
            "fax_number": "901-398-1987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1273 E RAINES RD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381165816",
            "telephone_number": "901-398-6435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLS",
        "first_name": "RAGONVA",
        "middle_name": "SHANTE",
        "name_prefix": "Ms.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-25",
        "last_updated": "2017-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "8059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RAGONVA",
            "last_name": "WALLS",
            "middle_name": "SHANTE",
            "prefix": "MS.",
            "credential": "DDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kelly Walls, PHARM.D.
• Kevin Avein Walls
• Latoya Walls, BSN, RN
• Miracle Ann Walls, DO
• Nanetta R. Walls, PHD
• Whitney Walls
• Aaron Walsh, M.D.
• Anna Marguerite Walsh, MD
• Janet Leigh Walsh, O.D.
• Lindsay Walsh, MS, RD, LDN, IBCLC

• General Practice Dentistry in Memphis, TN
• Providers in Memphis, TN by specialty
• General Practice Dentistry in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2017; 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.