Kevin Martin Walsh, DDS MS

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

00580 Issued in MO

Practice address

6651 Chippewa
Suite 221
St Louis, MO 63109-2531

Phone

(314) 351-2588

Fax

(314) 351-3334

NPI assigned

Nov 27, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1164585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1518033174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6651 CHIPPEWA SUITE 221",
            "address_2": "LANSDOWNE MEDICAL BUILDING",
            "city": "ST LOUIS",
            "state": "MO",
            "postal_code": "631092531",
            "telephone_number": "314-351-2588",
            "fax_number": "314-351-3334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6651 CHIPPEWA",
            "address_2": "SUITE 221",
            "city": "ST LOUIS",
            "state": "MO",
            "postal_code": "631092531",
            "telephone_number": "314-351-2588",
            "fax_number": "314-351-3334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALSH",
        "first_name": "KEVIN",
        "middle_name": "MARTIN",
        "name_prefix": "Dr.",
        "credential": "DDS MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MO",
            "license": "00580",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DELTA DENTAL INSURANCE",
            "identifier": "2012963",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jane Walsh
• Jarrett Elbert Walsh, MD
• Jennifer Walsh, LPC
• Jodi Walsh, A-GNP-C
• Katie Walsh, MSN, ACNPC-AG
• Kristi Walsh
• McKenna Emerson Walsh
• Riley Walsh
• Robert Phillip Walsh, CRNA
• Ryan Walsh, PH.D.

• Orthodontics and Dentofacial Orthopedics Dentistry in St Louis, MO
• Providers in St Louis, MO by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Missouri

• 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.