Provider Demographics
NPI:1245235019
Name:WALKER, DANIEL JOHN (DDS)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:JOHN
Last Name:WALKER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:76-6225 KUAKINI HWY
Mailing Address - Street 2:STE A101
Mailing Address - City:KAILUA KONA
Mailing Address - State:HI
Mailing Address - Zip Code:96740-3212
Mailing Address - Country:US
Mailing Address - Phone:808-329-8180
Mailing Address - Fax:808-334-1892
Practice Address - Street 1:76-6225 KUAKINI HWY
Practice Address - Street 2:STE A101
Practice Address - City:KAILUA KONA
Practice Address - State:HI
Practice Address - Zip Code:96740-3212
Practice Address - Country:US
Practice Address - Phone:808-329-8180
Practice Address - Fax:808-334-1892
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI14061223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice