Active NPI
Crayton Ross Walker, D.D.S., M.D.
- Oral and Maxillofacial Pathology Dentistry
- Salt Lake City, UT
National Provider Identifier
1053456368
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Oral and Maxillofacial Pathology Dentistry
- License
- 168208-1205
- Practice address
- 1060 E 100 S
204
Salt Lake City, UT 84102-1501 - Phone
- (801) 322-5423
- Fax
- (801) 364-9437
- NPI assigned
- Feb 21, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Oral and Maxillofacial Pathology Dentistry | 1223P0106X | 168208-1205 | UT | Primary |
Addresses
Primary practice location
1060 E 100 S
204
Salt Lake City, UT 84102-1501
Mailing address
1060 E 100 S
204
Salt Lake City, UT 84102-1501
Phone (801) 322-5423
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective May 8, 2016 through May 8, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 168208-1205 | UT | MD | Oral and Maxillofacial Pathology Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172016000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1053456368",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1060 E 100 S",
"address_2": "204",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841021501",
"telephone_number": "801-322-5423",
"fax_number": "801-364-9437"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1060 E 100 S",
"address_2": "204",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841021501",
"telephone_number": "801-322-5423",
"fax_number": "801-364-9437"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALKER",
"first_name": "CRAYTON",
"middle_name": "ROSS",
"credential": "D.D.S., M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0106X",
"taxonomy_group": "",
"desc": "Dentist, Oral and Maxillofacial Pathology",
"state": "UT",
"license": "168208-1205",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salt Lake City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.