Provider Demographics
NPI:1215589767
Name:WALKER, JOSHUA ADAM (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:ADAM
Last Name:WALKER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3865 BUTTERMILK RD W
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:TN
Mailing Address - Zip Code:37763-6929
Mailing Address - Country:US
Mailing Address - Phone:865-384-1718
Mailing Address - Fax:
Practice Address - Street 1:1011 WATERFORD PL
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:TN
Practice Address - Zip Code:37763-2686
Practice Address - Country:US
Practice Address - Phone:865-248-2199
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-15
Last Update Date:2022-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN113391223G0001X
IN12013247A122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Yes1223G0001XDental ProvidersDentistGeneral Practice