Shawn R Walton

Primary specialty

DentistTaxonomy code 122300000X

License

07610 Issued in IA

Legal business name

SHAWN R WALTON

Practice address

2928 Hamilton Blvd
Suite 102
Sioux City, IA 51104

Phone

(712) 255-7607

Fax

(712) 255-4507

NPI assigned

Aug 31, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Shawn R Walton, DDS

Title

Dentist

Phone

(712) 255-7607

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Walton Dental Health Former legal business name

Locations

Practitioners 1

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

• Jerry Curtis Prahl, DDS

  • Dentist
  • Sioux City, IA
  • NPI 1538240924
  NPD (past)

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1659482206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2928 HAMILTON BLVD",
            "address_2": "SUITE 102",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "51104",
            "telephone_number": "712-255-7607",
            "fax_number": "712-255-4507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2928 HAMILTON BLVD",
            "address_2": "SUITE 102",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "51104",
            "telephone_number": "712-255-7607",
            "fax_number": "712-255-4507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAWN R WALTON",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WALTON",
        "authorized_official_first_name": "SHAWN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "712-255-7607",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "IA",
            "license": "07610",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "IA",
            "license": "08441",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025415600",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0102343",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Walton Dental Health",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Dentist in Sioux City, IA
• Providers in Sioux City, IA by specialty
• Dentist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.