Individual provider Active NPI

Steven R. Walls, DMD

  • Dentist
  • El Dorado Hills, CA
National Provider Identifier
1750477501
Registry record updated Jan 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
41692 Issued in CA
Practice address
1010 White Rock Rd Ste 500
El Dorado Hills, CA 95762-5627
Phone
(916) 939-0889
Fax
(916) 939-0477
NPI assigned
Oct 5, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 41692 CA Primary

Addresses

Primary practice location

1010 White Rock Rd Ste 500
El Dorado Hills, CA 95762-5627

Mailing address

1010 White Rock Rd Ste 500
El Dorado Hills, CA 95762-5627
Phone (916) 939-0889

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20250113001861 CA Practitioner - Dentist 2062940521 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
41692CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Sound Sleep Solutions CurrentSince Apr 3, 2024 Accepting new patients
Steven R Walls, DMD a Professional Corporation CurrentSince Jun 9, 2024 Accepting new patients

Locations

1010 White Rock Rd
Ste 500
El Dorado Hills, CA 95762
Phone (916) 260-9683

Organizations & group practices 2

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": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736380800000",
    "number": "1750477501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 WHITE ROCK RD STE 500",
            "city": "EL DORADO HILLS",
            "state": "CA",
            "postal_code": "957625627",
            "telephone_number": "916-939-0889",
            "fax_number": "916-939-0477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 WHITE ROCK RD STE 500",
            "city": "EL DORADO HILLS",
            "state": "CA",
            "postal_code": "957625627",
            "telephone_number": "916-939-0889",
            "fax_number": "916-939-0477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLS",
        "first_name": "STEVEN",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2025-01-09",
        "certification_date": "2025-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "41692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Dorado Hills, CA

Sources for this page

Verify at the official NPI Registry.