Healthcare Provider Details

I. General information

NPI: 1871512079
Provider Name (Legal Business Name): WALKER FAMILY DENTISTRY P C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 10/20/2025
Certification Date: 10/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10177 ALLISONVILLE RD SUITE 101
FISHERS IN
46038-2014
US

IV. Provider business mailing address

10177 ALLISONVILLE RD SUITE 101
FISHERS IN
46038-2014
US

V. Phone/Fax

Practice location:
  • Phone: 317-849-8550
  • Fax: 317-841-0121
Mailing address:
  • Phone: 317-849-8550
  • Fax: 317-841-0121

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number12009157
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: DR. GARY F WALKER
Title or Position: PRESIDENT
Credential: D.D.S.
Phone: 317-849-8550