Individual provider Active NPI

Abbie Lee Walker, DDS, MS

  • Pediatric Dentistry
  • Ann Arbor, MI
National Provider Identifier
1588957187
Registry record updated Apr 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
2901020800 Issued in MI
Practice address
U of M School of Dentistry, 1011 N University Ave
Pediatric Clinic, Room 2075
Ann Arbor, MI 48109
Phone
(734) 764-1523
Fax
(734) 615-7294
NPI assigned
May 16, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 21, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2901020800 MI
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X 2901020800 MI Primary

Addresses

Primary practice location

U of M School of Dentistry, 1011 N University Ave
Pediatric Clinic, Room 2075
Ann Arbor, MI 48109

Mailing address

255 Crest St
Ann Arbor, MI 48103-4315
Phone (616) 308-9592

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20160315000399 MI Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 5698096584

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
2901020800MIMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1305504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618963200000",
    "number": "1588957187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 CREST ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481034315",
            "telephone_number": "616-308-9592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "U OF M SCHOOL OF DENTISTRY, 1011 N UNIVERSITY AVE",
            "address_2": "PEDIATRIC CLINIC, ROOM 2075",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "48109",
            "telephone_number": "734-764-1523",
            "fax_number": "734-615-7294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "ABBIE",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "DDS, MS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-05-16",
        "last_updated": "2021-04-21",
        "certification_date": "2021-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901020800",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MI",
            "license": "2901020800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.