Active NPI
Kendall Elyse Walker, RDH
- Dental Hygienist
- Meridian, ID
National Provider Identifier
1396425864
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- DH-4033
- Practice address
- 1910 S Meridian Rd Ste 150
Meridian, ID 83642-9061 - Phone
- (925) 813-5110
- NPI assigned
- Jul 20, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | DH-4033 | ID | Primary |
Addresses
Primary practice location
1910 S Meridian Rd Ste 150
Meridian, ID 83642-9061
Mailing address
1674 W Henrys Fork Dr
Meridian, ID 83642-7328
Phone (925) 813-5110
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DH-4033 | ID | MD | Dental Hygienist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern Springs Dental PLLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Practice Dentistry
- Meridian, ID
- NPI 1730348236
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1689811200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1710806400000",
"number": "1396425864",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1674 W HENRYS FORK DR",
"city": "MERIDIAN",
"state": "ID",
"postal_code": "836427328",
"telephone_number": "925-813-5110"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1910 S MERIDIAN RD STE 150",
"city": "MERIDIAN",
"state": "ID",
"postal_code": "836429061",
"telephone_number": "925-813-5110"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALKER",
"first_name": "KENDALL",
"middle_name": "ELYSE",
"credential": "RDH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-07-20",
"last_updated": "2024-03-19",
"certification_date": "2024-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "ID",
"license": "DH-4033",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Meridian, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 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.