NPIMap

Organization Active NPI

Walton Dental, PLLC

Doing business as Walton Blvd. Dental

  • General Practice Dentistry
  • Bentonville, AR
National Provider Identifier
1427519669
Registry record updated Feb 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
WALTON DENTAL, PLLC
Doing business as
Walton Blvd. Dental
Practice address
104 S Walton Blvd
Bentonville, AR 72712-5747
Phone
(479) 273-3757
NPI assigned
Mar 29, 2019
Last updated
Feb 18, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2020

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

Authorized official

Name
Renee McBay
Title
Credentialing Manager
Phone
(918) 998-0996

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

104 S Walton Blvd
Bentonville, AR 72712-5747

Mailing address

400 Riverwalk Ter Ste 250
Jenks, OK 74037-5619
Phone (918) 988-0996

Other names 1

  • Walton Blvd. Dental Doing business as

National Provider Directory

National Provider Directory

Locations

104 S Walton Blvd
Bentonville, AR 72712
Phone (479) 273-3757

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1553817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581984000000",
    "number": "1427519669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 RIVERWALK TER STE 250",
            "city": "JENKS",
            "state": "OK",
            "postal_code": "740375619",
            "telephone_number": "918-988-0996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 S WALTON BLVD",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727125747",
            "telephone_number": "479-273-3757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALTON DENTAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-29",
        "last_updated": "2020-02-18",
        "certification_date": "2020-02-18",
        "status": "A",
        "authorized_official_last_name": "MCBAY",
        "authorized_official_first_name": "RENEE",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "918-998-0996"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Walton Blvd. Dental",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Walton Blvd. Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bentonville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2020; 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.