Provider Demographics
NPI:1548336902
Name:WALKER, JESSICA SPRING (DDS)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:SPRING
Last Name:WALKER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:CALDWELL
Other - Last Name:SPRING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3919 N MACARTHUR
Mailing Address - Street 2:
Mailing Address - City:WARR ACRES
Mailing Address - State:OK
Mailing Address - Zip Code:73122
Mailing Address - Country:US
Mailing Address - Phone:405-787-7827
Mailing Address - Fax:405-470-1838
Practice Address - Street 1:3919 N MACARTHUR
Practice Address - Street 2:
Practice Address - City:WARR ACRES
Practice Address - State:OK
Practice Address - Zip Code:73122
Practice Address - Country:US
Practice Address - Phone:405-787-7827
Practice Address - Fax:405-470-1838
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2008-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK5799122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200057670AMedicaid