NPIMap

Organization Active NPI

Fargo Moorhead Dental & Dentures P C

  • General Practice Dentistry
  • Fargo, ND
National Provider Identifier
1619355484
Registry record updated May 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
FARGO MOORHEAD DENTAL & DENTURES P C
Practice address
4302 13TH Ave S
Suite 10
Fargo, ND 58103-3395
Phone
(701) 281-8000
NPI assigned
May 13, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2015

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

Authorized official

Name
Dr. Devin Walker Walker, DDS
Title
Owner
Phone
(701) 281-8000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

4302 13TH Ave S
Suite 10
Fargo, ND 58103-3395

Mailing address

4302 13TH Ave S
Suite 10
Fargo, ND 58103-3395
Phone (701) 281-8000

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1431475200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431475200000",
    "number": "1619355484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4302 13TH AVE S",
            "address_2": "SUITE 10",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581033395",
            "telephone_number": "701-281-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4302 13TH AVE S",
            "address_2": "SUITE 10",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581033395",
            "telephone_number": "701-281-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FARGO MOORHEAD DENTAL & DENTURES P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-13",
        "last_updated": "2015-05-13",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "DEVIN",
        "authorized_official_middle_name": "WALKER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "701-281-8000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2015; 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.