Provider Demographics
NPI:1275192890
Name:WALKER, ELLEN (DDS)
Entity Type:Individual
Prefix:DR
First Name:ELLEN
Middle Name:
Last Name:WALKER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1170 S PERRY ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80219-3829
Mailing Address - Country:US
Mailing Address - Phone:812-618-6655
Mailing Address - Fax:
Practice Address - Street 1:2250 S PARKER RD
Practice Address - Street 2:STE 150
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80231-3519
Practice Address - Country:US
Practice Address - Phone:303-595-5454
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-07
Last Update Date:2019-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN.002039911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice