Individual provider Active NPI

Christian Walker, DMD

  • General Practice Dentistry
  • Claxton, GA
National Provider Identifier
1992497689
Registry record updated Oct 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN123085 Issued in GA
Practice address
201 E Long St
Claxton, GA 30417-1409
Phone
(912) 739-1595
NPI assigned
May 22, 2023
Last updated
Oct 28, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN123085 GA Primary

Addresses

Primary practice location

201 E Long St
Claxton, GA 30417-1409

Mailing address

5 Pipers Pond LN
Savannah, GA 31404-1122
Phone (770) 330-6239

Other practice location 1

1130 Brampton Ave
Statesboro, GA 30458-0847
Phone (912) 764-3724

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
DN123085GAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Claxton Family Dentistry LLC PastSince Nov 3, 2024 Accepting new patients
Premier Dental Wellness LLC General Practice PastSince May 12, 2024 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1684713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730073600000",
    "number": "1992497689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 PIPERS POND LN",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314041122",
            "telephone_number": "770-330-6239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 E LONG ST",
            "city": "CLAXTON",
            "state": "GA",
            "postal_code": "304171409",
            "telephone_number": "912-739-1595"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1130 Brampton Ave",
            "address_purpose": "LOCATION",
            "city": "Statesboro",
            "state": "GA",
            "postal_code": "304580847",
            "country_code": "US",
            "telephone_number": "912-764-3724",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALKER",
        "first_name": "CHRISTIAN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-05-22",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN123085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Claxton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2024; 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.