Individual provider Active NPI

Scott A. Walker, DDS

  • General Practice Dentistry
  • Vacaville, CA
National Provider Identifier
1508984253
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
29120 Issued in CA
Practice address
301 Alamo Dr Ste I
Vacaville, CA 95688-4246
Phone
(707) 446-4644
Fax
(707) 446-0125
NPI assigned
Mar 27, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 29120 CA Primary

Addresses

Primary practice location

301 Alamo Dr Ste I
Vacaville, CA 95688-4246

Mailing address

301 Alamo Dr Ste I
Vacaville, CA 95688-4246
Phone (707) 446-4644

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

LicenseStateTypeSpecialty
29120CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
KJ Cabugao DDS Inc General Practice PastSince Apr 17, 2020 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.

NPI Registry JSON

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508984253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 ALAMO DR STE I",
            "city": "VACAVILLE",
            "state": "CA",
            "postal_code": "956884246",
            "telephone_number": "707-446-4644",
            "fax_number": "707-446-0125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 ALAMO DR STE I",
            "city": "VACAVILLE",
            "state": "CA",
            "postal_code": "956884246",
            "telephone_number": "707-446-4644",
            "fax_number": "707-446-0125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "SCOTT",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "29120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vacaville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.