Provider Demographics
NPI:1962645069
Name:WALKER, REBECCA J (DDS)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:J
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 1:10177 ALLISONVILLE RD
Mailing Address - Street 2:SUITE # 101
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46038-2073
Mailing Address - Country:US
Mailing Address - Phone:317-849-8550
Mailing Address - Fax:317-841-0121
Practice Address - Street 1:10177 ALLISONVILLE RD
Practice Address - Street 2:SUITE # 101
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46038-2073
Practice Address - Country:US
Practice Address - Phone:317-849-8550
Practice Address - Fax:317-841-0121
Is Sole Proprietor?:No
Enumeration Date:2009-04-20
Last Update Date:2009-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12009452B1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice