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DR. NATHAN FREDERICK WALTERS DMD NPI 1265424907


NPI Information

NPI: 1265424907
Provider Name: DR. NATHAN FREDERICK WALTERS, DMD
Classification: Dentist - 1223S0112X
Entity Type: Individual

Specialization: Oral and Maxillofacial Surgery

PECOS Registration: Yes

Address:
2800 CANNONS LN STE 200
LOUISVILLE, KY
ZIP 40205
Phone: (502) 454-4885
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DR. Nathan Frederick Walters, DMD is an oral and maxillofacial surgery dentist in Louisville, KY with 20 years of experience. The provider is an oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. DR. Nathan Frederick Walters, DMD NPI is 1265424907. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF TEXAS MEDICAL SCHOOL AT HOUSTON
Graduation Year:2004

The provider's business location address is:

2800 CANNONS LN STE 200
LOUISVILLE, KY
ZIP 40205-164
Phone: (502) 454-4885
Fax: (502) 452-1926

The NPI 1265424907 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 8/18/2005 and was last updated on 11/12/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223S0112XDentistOral and Maxillofacial Surgery8066KENTUCKYYes
2204E00000XOral & Maxillofacial Surgery8066KENTUCKYNo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1000000339061OTHERKENTUCKYBC/BS
2200498320MEDICAIDINDIANA
360002789MEDICAIDKENTUCKY
464082688MEDICAIDKENTUCKY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.