Active NPI
Matthew Evann Walker, DDS
- Dentist
- Tahlequah, OK
National Provider Identifier
1619070752
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 5559
- Practice address
- 221 E. Downing St
Tahlequah, OK 74464 - Phone
- (918) 456-4441
- Fax
- (918) 456-2523
- NPI assigned
- Sep 6, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 5559 | OK | Primary |
Addresses
Primary practice location
221 E. Downing St
Tahlequah, OK 74464
Mailing address
221 E. Downing St
Tahlequah, OK 74464
Phone (918) 456-4441
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
| License | State | Type | Specialty |
|---|---|---|---|
| 5559 | OK | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157500800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1512432000000",
"number": "1619070752",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "221 E. DOWNING ST",
"city": "TAHLEQUAH",
"state": "OK",
"postal_code": "74464",
"telephone_number": "918-456-4441",
"fax_number": "918-456-2523"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "221 E. DOWNING ST",
"city": "TAHLEQUAH",
"state": "OK",
"postal_code": "74464",
"telephone_number": "918-456-4441",
"fax_number": "918-456-2523"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALKER",
"first_name": "MATTHEW",
"middle_name": "EVANN",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-06",
"last_updated": "2017-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "OK",
"license": "5559",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tahlequah, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.