Mason Lee Walker, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

10930 Issued in KY

Practice address

1001 Gibson Bay Dr Ste 202
Richmond, KY 40475-3544

Phone

(859) 625-0204

NPI assigned

Apr 3, 2023

Last updated

Jun 5, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Highland Dental Dre PLLC

  • Dentist
  • Richmond, KY
  • NPI 1043050628
  NPD

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

{
    "created_epoch": "1680480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717545600000",
    "number": "1235834003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1312 GRAY HAWK RD APT B",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405027011",
            "telephone_number": "859-699-6935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 GIBSON BAY DR STE 202",
            "city": "RICHMOND",
            "state": "KY",
            "postal_code": "404753544",
            "telephone_number": "859-625-0204"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "740 S Limestone Kentucky Clinic Second Floor",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405360001",
            "country_code": "US",
            "telephone_number": "859-323-3368",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALKER",
        "first_name": "MASON",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-04-03",
        "last_updated": "2024-06-05",
        "certification_date": "2024-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "10930",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wal-Mart Stores East LP (Walmart Pharmacy 10-0719)
• Wal-Mart Stores East, LP (Vision Center 30-0719)
• Walgreen Co (Walgreens #19411)
• Walgreen Co (Rite Aid #18161)
• Walgreen Co (Walgreens #15561)
• Natasha Walker
• Davonna Wallen, LMT
• Deann Wallen
• Lauren Faith Walters
• Matthew Walters, PT, DPT

• General Practice Dentistry in Richmond, KY
• Providers in Richmond, KY by specialty
• General Practice Dentistry in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2024; 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.