Active NPI
Crystal Rachelle Walker, D.D.S.
- Pediatric Dentistry
- Wichita, KS
National Provider Identifier
1619983681
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 603
- Practice address
- 6943 W 37TH St N
Wichita, KS 67205-9302 - Phone
- (316) 613-2077
- Fax
- (316) 613-2969
- NPI assigned
- Jul 31, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 603 | KS | Primary |
Addresses
Primary practice location
6943 W 37TH St N
Wichita, KS 67205-9302
Mailing address
6943 W 37TH St N
Wichita, KS 67205-9302
Phone (316) 613-2077
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200385980 A | Medicaid | KS |
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 |
|---|---|---|---|
| 603 | KS | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154304000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1476316800000",
"number": "1619983681",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6943 W 37TH ST N",
"city": "WICHITA",
"state": "KS",
"postal_code": "672059302",
"telephone_number": "316-613-2077",
"fax_number": "316-613-2969"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6943 W 37TH ST N",
"city": "WICHITA",
"state": "KS",
"postal_code": "672059302",
"telephone_number": "316-613-2077",
"fax_number": "316-613-2969"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALKER",
"first_name": "CRYSTAL",
"middle_name": "RACHELLE",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-31",
"last_updated": "2016-10-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "KS",
"license": "603",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200385980 A",
"state": "KS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wichita, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.