Phillip Gene Walton

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN008971 Issued in GA

Practice address

3995 Covington Hwy
Decatur, GA 30032-2645

Phone

(404) 284-6911

Fax

(404) 288-4165

NPI assigned

Jun 21, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Phillip G Walton DDS PC

  • General Practice Dentistry
  • Decatur, GA
  • NPI 1780744748
  NPD (past)

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350518400000",
    "number": "1730125568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3995 COVINGTON HWY",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300322645",
            "telephone_number": "404-284-6911",
            "fax_number": "404-288-4165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3995 COVINGTON HWY",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300322645",
            "telephone_number": "404-284-6911",
            "fax_number": "404-288-4165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTON",
        "first_name": "PHILLIP",
        "middle_name": "GENE",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-21",
        "last_updated": "2012-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN008971",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP MEDICADE",
            "identifier": "9180345",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00213056A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Helen Berg Walsh, P.T.
• Walter a Grage DDS PC
• Haley N Walters, PA
• Chauncey M Walton, FNP-BC
• Jewel Y Walton
• Relisha Nicole Walton
• Michelle Wan, MD
• Duanran Wang, MS
• Susan Annemarie Wang, M.D., M.P.H.
• Alana Alexandria Ward, MSW

• General Practice Dentistry in Decatur, GA
• Providers in Decatur, GA by specialty
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2012; 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.