Active NPI
Douglas Donald Walker, D.D.S.
- Dentist
- Charleston, SC
National Provider Identifier
1356605190
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 8129
- Practice address
- 776 Ellis Oaks Drive
Suite 3a
Charleston, SC 29412-7903 - Phone
- (843) 761-7380
- Fax
- (843) 761-7385
- NPI assigned
- Jun 26, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 30-023768 | OH | |
| Dentist | 122300000X | 8129 | SC | Primary |
Addresses
Primary practice location
776 Ellis Oaks Drive
Suite 3a
Charleston, SC 29412-7903
Mailing address
3751 S Live Oak Dr
Suite G
Moncks Corner, SC 29461-7903
Phone (843) 761-7380
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160623001258 | SC | Order and Referring Only - Oral Surgery | 5395036255 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30-023768 | OH | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| DW by DW, PC | Dentist | Current | Accepting new patients |
| Carnes Crossroads Dental P.a | Dentist | Past | Accepting new patients |
| Carnes Crossroads Dental Arts P.a. | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Dentist
- Moncks Corner, SC
- NPI 1316363047
-
- Dentist
- Charleston, SC
- NPI 1073492666
-
- Dental Clinic/Center
- Moncks Corner, SC
- NPI 1396981304
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1340668800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1756339200000",
"number": "1356605190",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3751 S LIVE OAK DR",
"address_2": "SUITE G",
"city": "MONCKS CORNER",
"state": "SC",
"postal_code": "294617903",
"telephone_number": "843-761-7380",
"fax_number": "843-761-7385"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "776 ELLIS OAKS DRIVE",
"address_2": "SUITE 3A",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "294127903",
"telephone_number": "843-761-7380",
"fax_number": "843-761-7385"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALKER",
"first_name": "DOUGLAS",
"middle_name": "DONALD",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-06-26",
"last_updated": "2025-08-28",
"certification_date": "2025-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "OH",
"license": "30-023768",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "SC",
"license": "8129",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Charleston, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2025; 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.