Matthew Walls, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D5393 Issued in OK

Practice address

12627 S Highway 51
Coweta, OK 74429-6476

Phone

(918) 486-0039

Fax

(918) 486-0097

NPI assigned

Jan 28, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

• Walls Family Dentistry, Inc

  • Dental Clinic/Center
  • Coweta, OK
  • NPI 1679740898
  Authorized official Same address or phone

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

{
    "created_epoch": "1169942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238371200000",
    "number": "1770639981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12627 S HIGHWAY 51",
            "city": "COWETA",
            "state": "OK",
            "postal_code": "744296476",
            "telephone_number": "918-486-0039",
            "fax_number": "918-486-0097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12627 S HIGHWAY 51",
            "city": "COWETA",
            "state": "OK",
            "postal_code": "744296476",
            "telephone_number": "918-486-0039",
            "fax_number": "918-486-0097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLS",
        "first_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-28",
        "last_updated": "2009-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OK",
            "license": "D5393",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D8106",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Terence J Vincent, DPM
• Wal-Mart Stores East LP (Walmart Pharmacy 10-0374)
• Walgreen Co (Walgreens #15756)
• Dennis Leo Wallis, DDS
• Walls Family Dentistry, Inc
• Way Maker Midwifery
• Laura West, DPT
• Delana Denise Westman, PHYSICAL THERAPIST
• Rick W Williams, MED, ED.S, ED. D
• Taylor Williams

• General Practice Dentistry in Coweta, OK
• Providers in Coweta, OK by specialty
• General Practice Dentistry in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.