MEDICARE: DR. JENNIFER M. WALKER D.M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223P0221X	Pediatric Dentistry	56223	CA

General Provider Information

NPI Number	:	1841269255
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JENNIFER M. WALKER D.M.D.

Provider Business Mailing Address
First Line	:	69175 RAMON RD # A
Second Line	:
City	:	CATHEDRAL CITY
State	:	CA
Zip	:	92234-3344
Country	:	US
Telephone Number	:	760-321-6776
Fax Number	:

Provider Business Practice Location Address
First Line	:	69175 RAMON RD
Second Line	:
City	:	CATHEDRAL CITY
State	:	CA
Zip	:	92234-3344
Country	:	US
Telephone Number	:	760-321-6776
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/16/2006
Last Update Date	:	03/05/2019

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