Active NPI
Newell A Walther, D.D.S.
- General Practice Dentistry
- Wasilla, AK
National Provider Identifier
1992843197
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 1038
- Practice address
- 1700 Bogard Rd
Suite 204
Wasilla, AK 99654-6533 - Phone
- (907) 376-9449
- Fax
- (907) 376-9339
- NPI assigned
- Feb 1, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 1038 | AK | Primary |
Addresses
Primary practice location
1700 Bogard Rd
Suite 204
Wasilla, AK 99654-6533
Mailing address
1700 Bogard Rd
Suite 204
Wasilla, AK 99654-6533
Phone (907) 376-9449
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DD29612 | Medicaid | AK |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1038 | AK | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170288000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1992843197",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1700 BOGARD RD",
"address_2": "SUITE 204",
"city": "WASILLA",
"state": "AK",
"postal_code": "996546533",
"telephone_number": "907-376-9449",
"fax_number": "907-376-9339"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1700 BOGARD RD",
"address_2": "SUITE 204",
"city": "WASILLA",
"state": "AK",
"postal_code": "996546533",
"telephone_number": "907-376-9449",
"fax_number": "907-376-9339"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALTHER",
"first_name": "NEWELL",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "AK",
"license": "1038",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "DD29612",
"state": "AK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wasilla, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.