Healthcare Provider Details

I. General information

NPI: 1013694306
Provider Name (Legal Business Name): JOSHUA J WALKER DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2023
Last Update Date: 06/12/2024
Certification Date: 06/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

513 WHITE OAK ST STE D
ASHEBORO NC
27203-4770
US

IV. Provider business mailing address

513 WHITE OAK ST STE D
ASHEBORO NC
27203-4770
US

V. Phone/Fax

Practice location:
  • Phone: 336-626-7232
  • Fax:
Mailing address:
  • Phone: 336-626-7232
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number13742
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: