Individual provider Active NPI

Walter Caleb Stallings, DMD

  • General Practice Dentistry
  • Gulf Breeze, FL
National Provider Identifier
1790520211
Registry record updated Aug 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
30741 Issued in FL
Practice address
4311 Gulf Breeze Pkwy
Gulf Breeze, FL 32563-9152
Phone
(850) 932-0831
NPI assigned
Jun 26, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2025

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 30741 FL Primary
General Practice Dentistry 1223G0001X 12554 TN

Addresses

Primary practice location

4311 Gulf Breeze Pkwy
Gulf Breeze, FL 32563-9152

Mailing address

4311 Gulf Breeze Pkwy
Gulf Breeze, FL 32563-9152
Phone (601) 527-4296

Other practice location 1

1212 Dodds Ave
Chattanooga, TN 37404-4754
Phone (601) 527-4296

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
12554TNMDAddiction (Substance Use Disorder) Counselor
30741FLMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Paul Quinlan DDS PL General Practice PastSince Aug 10, 2025 Accepting new patients

Organizations & group practices 1

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": "1719360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754438400000",
    "number": "1790520211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4311 GULF BREEZE PKWY",
            "city": "GULF BREEZE",
            "state": "FL",
            "postal_code": "325639152",
            "telephone_number": "601-527-4296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4311 GULF BREEZE PKWY",
            "city": "GULF BREEZE",
            "state": "FL",
            "postal_code": "325639152",
            "telephone_number": "850-932-0831"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1212 Dodds Ave",
            "address_purpose": "LOCATION",
            "city": "Chattanooga",
            "state": "TN",
            "postal_code": "374044754",
            "country_code": "US",
            "telephone_number": "601-527-4296",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STALLINGS",
        "first_name": "WALTER",
        "middle_name": "CALEB",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-26",
        "last_updated": "2025-08-06",
        "certification_date": "2025-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "30741",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "12554",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gulf Breeze, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2025; 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.