Individual provider Active NPI

Patrick E. Walker, D.D.S.

  • Prosthodontics
  • San Jose, CA
National Provider Identifier
1669764346
Registry record updated May 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
25646 Issued in CA
Practice address
827 Blossom Hill Rd Ste W8
San Jose, CA 95123-2701
Phone
(408) 578-0240
Fax
(408) 578-0750
NPI assigned
May 12, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 12, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthodontics 1223P0700X 25646 CA Primary

Addresses

Primary practice location

827 Blossom Hill Rd Ste W8
San Jose, CA 95123-2701

Mailing address

827 Blossom Hill Rd Ste W8
San Jose, CA 95123-2701
Phone (408) 578-0240

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

LicenseStateTypeSpecialty
25646CAMDProsthodontist

NPI Registry JSON

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

{
    "created_epoch": "1305158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305158400000",
    "number": "1669764346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "827 BLOSSOM HILL RD STE W8",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951232701",
            "telephone_number": "408-578-0240",
            "fax_number": "408-578-0750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "827 BLOSSOM HILL RD STE W8",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951232701",
            "telephone_number": "408-578-0240",
            "fax_number": "408-578-0750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "PATRICK",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-05-12",
        "last_updated": "2011-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "CA",
            "license": "25646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2011; 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.