Kyle Walton, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

25583 Issued in TX

Practice address

1553 FM 685
Suite 400
Pflugerville, TX 78660-3576

Phone

(512) 989-3330

Fax

(512) 251-1766

NPI assigned

Jun 16, 2010

Last updated

Jan 11, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Pflugerville Modern Dentistry PC

  dba Pflugerville Modern Dentistry

  • General Practice Dentistry
  • Pflugerville, TX
  • NPI 1992099519
  NPD (past)

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

{
    "created_epoch": "1276646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326240000000",
    "number": "1285955047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1553 FM 685",
            "address_2": "SUITE 400",
            "city": "PFLUGERVILLE",
            "state": "TX",
            "postal_code": "786603576",
            "telephone_number": "512-989-3330",
            "fax_number": "512-251-1766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1553 FM 685",
            "address_2": "SUITE 400",
            "city": "PFLUGERVILLE",
            "state": "TX",
            "postal_code": "786603576",
            "telephone_number": "512-989-3330",
            "fax_number": "512-251-1766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTON",
        "first_name": "KYLE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-16",
        "last_updated": "2012-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "25583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wal-Mart Store Texas, LLC (Wal-Mart Vision Center 30-5479)
• Wal-Mart Stores Texas LLC (Walmart Pharmacy 10-5479)
• Walgreen Co (Walgreens #03159)
• Walgreen Co (Walgreens # 13446)
• Walgreen Co (Walgreens # 11568)
• Angela Ward
• Rebecca Suzanne Warner, L.AC.
• Heidi Waters, MA, LMFT
• Kendrick Watkins, M.D.
• Sarah Weaver, LPC

• General Practice Dentistry in Pflugerville, TX
• Providers in Pflugerville, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2012; 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.