Individual provider Active NPI

Laquia A. Walker-Vinson, D.D.S, MPH

  • Pediatric Dentistry
  • Indianapolis, IN
National Provider Identifier
1821095308
Registry record updated Aug 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
12010589A Issued in IN
Practice address
705 Riley Hospital Dr
Suite 4205
Indianapolis, IN 46202-5109
Phone
(317) 944-9604
Fax
(317) 948-0760
NPI assigned
Jun 30, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 12010589A IN Primary

Addresses

Primary practice location

705 Riley Hospital Dr
Suite 4205
Indianapolis, IN 46202-5109

Mailing address

705 Riley Hospital Dr Ste 4205
Indianapolis, IN 46202-5109
Phone (317) 944-9604

Other identifiers 1

IdentifierTypeStateIssuer
200515490MedicaidIN

Other names 1

  • Dr. Laquia A Vinson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20150225002222 IN Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 7113243734

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
University Pediatric Dentistry Associates Pediatric Dentistry Past 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": "1120089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787529600000",
    "number": "1821095308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 RILEY HOSPITAL DR STE 4205",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025109",
            "telephone_number": "317-944-9604",
            "fax_number": "317-948-0760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 RILEY HOSPITAL DR",
            "address_2": "SUITE 4205",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025109",
            "telephone_number": "317-944-9604",
            "fax_number": "317-948-0760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER-VINSON",
        "first_name": "LAQUIA",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "D.D.S, MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-30",
        "last_updated": "2026-08-24",
        "certification_date": "2026-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "IN",
            "license": "12010589A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200515490",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAQUIA",
            "last_name": "VINSON",
            "middle_name": "A",
            "prefix": "DR.",
            "credential": "D.D.S, MPH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.