Kelly Walker, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

G100001047 Issued in DE

Practice address

1991 Pulaski Hwy Ste 1
Bear, DE 19701-1708

Phone

(302) 832-2200

Fax

(302) 832-2029

NPI assigned

Jul 26, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in DE

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Pike Creek Dental, LLC

  • Durable Medical Equipment & Medical Supplies
  • Wilmington, DE
  • NPI 1457895849
  NPD (past)

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580169600000",
    "number": "1114941986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1991 PULASKI HWY",
            "city": "BEAR",
            "state": "DE",
            "postal_code": "197011708",
            "telephone_number": "302-832-2200",
            "fax_number": "302-832-2029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1991 PULASKI HWY STE 1",
            "city": "BEAR",
            "state": "DE",
            "postal_code": "197011708",
            "telephone_number": "302-832-2200",
            "fax_number": "302-832-2029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "KELLY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-26",
        "last_updated": "2020-01-28",
        "certification_date": "2020-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "DE",
            "license": "G100001047",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000903831",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• VN Health LLC
• Voice of Hope Health Care Services LLC
• Theresa Wadiak
• Heather H. Wagner, PHARM.D
• Walgreen Co
• Terri Ann Wallace, RN
• Jaclyn Marie Walsh, PA-C
• Erin Bree Ward, PNP
• John J Wasniewski III, DMD
• Naieshia Watson

• Dentist in Bear, DE
• Providers in Bear, DE by specialty
• Dentist in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.