John James Walsh, Jr., DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

30-021154 Issued in OH

Practice address

4664 Mahoning Ave NW
Warren, OH 44483-1419

Phone

(330) 847-8122

NPI assigned

Jun 7, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• John James Walsh, DMD, LLC

  • General Practice Dentistry
  • Warren, OH
  • NPI 1568593192
  NPD (past)

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

{
    "created_epoch": "1181174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408924800000",
    "number": "1467655464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4664 MAHONING AVE NW",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444831419",
            "telephone_number": "330-847-8122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4664 MAHONING AVE NW",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444831419",
            "telephone_number": "330-847-8122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALSH, JR.",
        "first_name": "JOHN",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-07",
        "last_updated": "2014-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30-021154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sheoni Kinyada Walker
• Takara L Walker
• Colin Wesley Wallace
• Lindsay Allison Wallace
• Jahonna Christinia Walsh
• Lauren Walsh
• Ian Jacob Walton, D.O.
• Robert A Walton, GENERAL DENTIST
• Joyce Kahtuma Wanyam Atenchong
• Allison Judith Ward, CT

• General Practice Dentistry in Warren, OH
• Providers in Warren, OH by specialty
• General Practice Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2014; 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.

Verify at the official NPI Registry.