Individual provider Active NPI

Spencer Wallace Walker, D.D.S.

  • General Practice Dentistry
  • Eagle Grove, IA
National Provider Identifier
1154613750
Registry record updated Jan 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
08812 Issued in IA
Practice address
322 S Commercial Ave
Eagle Grove, IA 50533-2210
Phone
(515) 448-4852
NPI assigned
May 14, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 12, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 08812 IA Primary

Addresses

Primary practice location

322 S Commercial Ave
Eagle Grove, IA 50533-2210

Mailing address

322 S Commercial Ave
Eagle Grove, IA 50533-2210
Phone (515) 448-4852

Other practice location 1

1303 11th Ave
Manson, IA 50563-5065
Phone (712) 469-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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

Enrollment IDStateProvider typePAC IDDetails
I20181226001261 IA Order and Referring Only - DentistPractitioner - Dentist 4284979089

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
08812IAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Walker Dental Consulting, L.L.C. General Practice Current Accepting new patients
Mother Ship LLC PastSince Dec 21, 2025 Accepting new patients

Locations

322 S Commercial Ave
Eagle Grove, IA 50533
Phone (515) 448-4852

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1305331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768176000000",
    "number": "1154613750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "322 S COMMERCIAL AVE",
            "city": "EAGLE GROVE",
            "state": "IA",
            "postal_code": "505332210",
            "telephone_number": "515-448-4852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "322 S COMMERCIAL AVE",
            "city": "EAGLE GROVE",
            "state": "IA",
            "postal_code": "505332210",
            "telephone_number": "515-448-4852"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1303 11th Ave",
            "address_purpose": "LOCATION",
            "city": "Manson",
            "state": "IA",
            "postal_code": "505635065",
            "country_code": "US",
            "telephone_number": "712-469-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALKER",
        "first_name": "SPENCER",
        "middle_name": "WALLACE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-05-14",
        "last_updated": "2026-01-12",
        "certification_date": "2026-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "08812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagle Grove, IA

Sources for this page

Verify at the official NPI Registry.