Benjamin Robert Walder, DDS MS

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

24486 Issued in TX

Practice address

301 Tanger Dr
Suite 225
Terrell, TX 75160-6651

Phone

(972) 215-7645

NPI assigned

Jun 6, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Credentials

Master of Science

Practice roles

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.

• Tyler Orthodontics, PLLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Tyler, TX
  • NPI 1134050156
  NPD Authorized official

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

{
    "created_epoch": "1244246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288656000000",
    "number": "1861628638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 TANGER DR",
            "address_2": "SUITE 225",
            "city": "TERRELL",
            "state": "TX",
            "postal_code": "751606651",
            "telephone_number": "310-413-8899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 TANGER DR",
            "address_2": "SUITE 225",
            "city": "TERRELL",
            "state": "TX",
            "postal_code": "751606651",
            "telephone_number": "972-215-7645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALDER",
        "first_name": "BENJAMIN",
        "middle_name": "ROBERT",
        "credential": "DDS MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-06",
        "last_updated": "2010-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "TX",
            "license": "24486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Visions Health Services
• Roy Voice Jr., LPTA
• Deborah L Vyborny, M.ED.
• Wal-Mart Stores Texas LLC
• Wal-Mart Stores Texas, LP
• Walgreen Co.
• Michael Bob Wallis, BCBA
• April Washburn
• Teressa Weaver
• Edward Weidow, D.O.

• Orthodontics and Dentofacial Orthopedics Dentistry in Terrell, TX
• Providers in Terrell, TX by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2010; 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.