Active NPI
Jennifer M. Walker, D.M.D.
- Pediatric Dentistry
- Cathedral City, CA
National Provider Identifier
1841269255
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 56223
- Practice address
- 69175 Ramon Rd
Cathedral City, CA 92234-3344 - Phone
- (760) 321-6776
- NPI assigned
- Mar 16, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 56223 | CA | Primary |
Addresses
Primary practice location
69175 Ramon Rd
Cathedral City, CA 92234-3344
Mailing address
69175 Ramon Rd # a
Cathedral City, CA 92234-3344
Phone (760) 321-6776
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA, TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130730000477 | CA | Order and Referring Only - Oral Surgery | 3577508928 | |
| I20210202002608 | TX | Order and Referring Only - Dentist | 3577508928 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 56223 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142467200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1551744000000",
"number": "1841269255",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "69175 RAMON RD # A",
"city": "CATHEDRAL CITY",
"state": "CA",
"postal_code": "922343344",
"telephone_number": "760-321-6776"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "69175 RAMON RD",
"city": "CATHEDRAL CITY",
"state": "CA",
"postal_code": "922343344",
"telephone_number": "760-321-6776"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALKER",
"first_name": "JENNIFER",
"middle_name": "M.",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-03-16",
"last_updated": "2019-03-05",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "CA",
"license": "56223",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cathedral City, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2019; 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.