Provider Demographics
NPI:1568440006
Name:WALKER, TIMOTHY FRANK (DDS)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:FRANK
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 1:10103 S 179TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68136-1967
Mailing Address - Country:US
Mailing Address - Phone:402-981-3848
Mailing Address - Fax:
Practice Address - Street 1:10103 S 179TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68136-1967
Practice Address - Country:US
Practice Address - Phone:402-981-3848
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-05
Last Update Date:2009-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE53601223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice