Healthcare Provider Details

I. General information

NPI: 1801473178
Provider Name (Legal Business Name): DAN WALKER DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DANIELLE NICOLE WALKER

II. Dates (important events)

Enumeration Date: 03/24/2021
Last Update Date: 12/09/2022
Certification Date: 12/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7212 REGIONAL ST
DUBLIN CA
94568-2326
US

IV. Provider business mailing address

700 S THE STRAND UNIT 203
OCEANSIDE CA
92054-3839
US

V. Phone/Fax

Practice location:
  • Phone: 925-462-1755
  • Fax:
Mailing address:
  • Phone: 661-477-0528
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number107991
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: