Individual provider Active NPI

Mark E Walker, DDS

  • General Practice Dentistry
  • Durham, NC
National Provider Identifier
1750397873
Registry record updated Jul 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
10002 Issued in NC
Practice address
2615 S Miami Blvd
Durham, NC 27703-5717
Phone
(919) 596-7447
NPI assigned
Jul 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 10002 NC Primary
General Practice Dentistry 1223G0001X 1980 NM

Addresses

Primary practice location

2615 S Miami Blvd
Durham, NC 27703-5717

Mailing address

2615 S Miami Blvd
Durham, NC 27703-5717
Phone (919) 596-7447

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141120001195 NM Order and Referring Only - DentistPractitioner - DentistPractitioner - Oral Surgery 5092937391

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1980NMMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
K. Jasinski, D.M.D., P.C. General Practice CurrentSince Jul 23, 2023 Accepting new patients
Dr. Pat Cassidy & Partners, PLLC PastSince Jul 23, 2023 Accepting new patients
Mark E. Walker DDS, PC PastSince Jan 3, 2002 Accepting new patients

Locations

2615 S Miami Blvd
Durham, NC 27703
Phone (919) 596-7447

Organizations & group practices 3

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.

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": "1689811200000",
    "number": "1750397873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2615 S MIAMI BLVD",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277035717",
            "telephone_number": "919-596-7447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2615 S MIAMI BLVD",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277035717",
            "telephone_number": "919-596-7447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "MARK",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2023-07-20",
        "certification_date": "2023-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "10002",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NM",
            "license": "1980",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

Verify at the official NPI Registry.