Healthcare Provider Details

I. General information

NPI: 1043799984
Provider Name (Legal Business Name): VICTORIA WALKER DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2018
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

145 RIVER LANDING DR UNIT 102
DANIEL ISLAND SC
29492-8612
US

IV. Provider business mailing address

78 SYCAMORE AVE UNIT 30145
CHARLESTON SC
29417-2707
US

V. Phone/Fax

Practice location:
  • Phone: 843-242-0645
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number11364
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: