Individual provider Active NPI

Ronald K Walker, DDS

  • General Practice Dentistry
  • Phoenix, AZ
National Provider Identifier
1609837277
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D3482 Issued in AZ
Practice address
4350 E Ray Rd
Suite 115
Phoenix, AZ 85044-4703
Phone
(480) 706-6165
Fax
(480) 706-4267
NPI assigned
Mar 31, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

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 D3482 AZ Primary

Addresses

Primary practice location

4350 E Ray Rd
Suite 115
Phoenix, AZ 85044-4703

Mailing address

4350 E Ray Rd
Suite 115
Phoenix, AZ 85044-4703
Phone (480) 706-6165

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20150721001476 AZ Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 1254644107

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D3482AZMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1609837277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4350 E RAY RD",
            "address_2": "SUITE 115",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850444703",
            "telephone_number": "480-706-6165",
            "fax_number": "480-706-4267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4350 E RAY RD",
            "address_2": "SUITE 115",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850444703",
            "telephone_number": "480-706-6165",
            "fax_number": "480-706-4267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "RONALD",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D3482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.