Andrea Walters, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

10931 Issued in KY

Practice address

1608 Cumberland Falls Hwy
Corbin, KY 40701-2725

Phone

(606) 523-2411

NPI assigned

May 25, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Deming Family Dentistry

  • Dental Clinic/Center
  • Corbin, KY
  • NPI 1144057324
  NPD

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

{
    "created_epoch": "1684972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684972800000",
    "number": "1639861610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1608 CUMBERLAND FALLS HWY",
            "city": "CORBIN",
            "state": "KY",
            "postal_code": "407012725",
            "telephone_number": "606-523-2411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1608 CUMBERLAND FALLS HWY",
            "city": "CORBIN",
            "state": "KY",
            "postal_code": "407012725",
            "telephone_number": "606-523-2411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTERS",
        "first_name": "ANDREA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-25",
        "last_updated": "2023-05-25",
        "certification_date": "2023-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KY",
            "license": "10931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kim Marie Walden, PT
• Walgreen Co (Walgreens #18301)
• Walgreen Co (Walgreens #12111)
• Joyce Lynn Waller, BS
• Dillon Kyle Walls, BS
• James William Walters Jr., BS
• Skyla Dawn Walters
• William Dakota Walters
• Bailee Alyce Wang, DO
• Boyang Wang, DO

• Dentist in Corbin, KY
• Providers in Corbin, KY by specialty
• Dentist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2023; 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.