Walter F. Tickner, DDS, Inc.

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

23418 Issued in CA

Legal business name

WALTER F. TICKNER, DDS, INC.

Practice address

1736 E 14TH St
San Leandro, CA 94577-4803

Phone

(510) 351-1400

Fax

(510) 351-3116

NPI assigned

Aug 17, 2006

Organization subpart

No

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

Authorized official

Name

Walter F. Tickner, DDSNPI 1962516211

Title

Owner/Dentist

Phone

(510) 351-1400

Specialties & licenses 1

Addresses

Other names 1

• Denture Center Other name

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Walter F. Tickner, DDS

  • Dentist
  • San Leandro, CA
  • NPI 1962516211
  NPD (past) Authorized official

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1073627345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1736 E 14TH ST",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945774803",
            "telephone_number": "510-351-1400",
            "fax_number": "510-351-3116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1736 E 14TH ST",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945774803",
            "telephone_number": "510-351-1400",
            "fax_number": "510-351-3116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALTER F. TICKNER, DDS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TICKNER",
        "authorized_official_first_name": "WALTER",
        "authorized_official_middle_name": "F.",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "510-351-1400",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "CA",
            "license": "23418",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Denture Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Walmart Inc.
• Walmart Inc.
• Walmart, Inc.
• Diane Sheryl Walsh
• Cherella Michaela Walston
• Rebecca Strong Walters, MA
• Stacie Louise Walton, M.D.
• Chanae' Wami
• Erica Wandner, PH.D.
• Joshua Wandro, MSW

• Dental Clinic/Center in San Leandro, CA
• Providers in San Leandro, CA by specialty
• Dental Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.