Robert Bruce Walter, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

23466 Issued in CA

Practice address

Llusd Special Care Dentistry
11092 Anderson St.
Loma Linda, CA 92350-0001

Phone

(909) 558-4611

Fax

(909) 558-0106

NPI assigned

Dec 19, 2006

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1336203199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "LLUSD SPECIAL CARE DENTISTRY",
            "address_2": "11092 ANDERSON ST.",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923500001",
            "telephone_number": "909-558-4611",
            "fax_number": "909-558-0106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "LLUSD SPECIAL CARE DENTISTRY",
            "address_2": "11092 ANDERSON ST.",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923500001",
            "telephone_number": "909-558-4611",
            "fax_number": "909-558-0106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTER",
        "first_name": "ROBERT",
        "middle_name": "BRUCE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "23466",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL LICENSE",
            "identifier": "23466",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rhett Jay Wallace, PHARMD
• Philip Harold Wallar, M.D.
• Walmart Inc.
• Colleen Jo Walsh Lang
• Michael H Walter, M.D.
• Robert Douglas Walter, DDS, MSD
• Elizabeth L Walters, M.D.
• Centoria Walton, LCSW
• Jennifer Carol Wamsley, RRT
• Annie Wang, M.D.

• Dentist in Loma Linda, CA
• Providers in Loma Linda, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.