Individual provider Active NPI

Martin Luther Walton III, D.D.S.

  • Pediatric Dentistry
  • Richmond, VA
National Provider Identifier
1407844509
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
0401008399 Issued in VA
Practice address
521 N 11TH St
Ped. Dent. Vcu School of Dentistry
Richmond, VA 23298-5045
Phone
(804) 828-0791
Fax
(804) 827-0163
NPI assigned
Oct 12, 2005
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 0401008399 VA Primary

Addresses

Primary practice location

521 N 11TH St
Ped. Dent. Vcu School of Dentistry
Richmond, VA 23298-5045

Mailing address

PO Box 980566
Ped. Dent. Vcu School of Dentistry
Richmond, VA 23298-0566
Phone (804) 828-0791

Other identifiers 2

IdentifierTypeStateIssuer
78-0361-3MedicaidVA
0007101OtherVADORAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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

Enrollment IDStateProvider typePAC IDDetails
I20170118002523 VA Order and Referring Only - DentistPractitioner - Dentist 2769668383

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1129075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1407844509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 980566",
            "address_2": "PED. DENT. VCU SCHOOL OF DENTISTRY",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232980566",
            "telephone_number": "804-828-0791",
            "fax_number": "804-827-0163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 N 11TH ST",
            "address_2": "PED. DENT. VCU SCHOOL OF DENTISTRY",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232985045",
            "telephone_number": "804-828-0791",
            "fax_number": "804-827-0163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTON",
        "first_name": "MARTIN",
        "middle_name": "LUTHER",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-12",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "VA",
            "license": "0401008399",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "78-0361-3",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DORAL",
            "identifier": "0007101",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

Verify at the official NPI Registry.