KIMBERLY WALTERS DMD
NPI 1710236799
Dentist in Minneapolis, MN

Q: What is Kimberly Walters's NPI number?

The NPI number for Kimberly Walters is 1710236799. It was assigned to this individual provider in the NPPES registry on September 5, 2012.

Q: What is Kimberly Walters's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Q: When was this NPI record last updated?

The NPPES record for Kimberly Walters was last updated on August 20, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since September 05, 2012PECOS Enrolled

701 PARK AVENUE SOUTH, MINNEAPOLIS, MN 55415(612) 873-3000 Get Directions Write a Review

NPPES record last updated: August 20, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Aug 20, 2026, Apr 22, 2020, Dec 10, 2015 (3 updates tracked since 2015).

On this page

About Kimberly Walters Dmd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KIMBERLY WALTERS DMD (NPI 1710236799) is an individual dentist in Minneapolis, Minnesota, licensed in Arizona (D008447) and active in the NPI registry since September 2012. She is enrolled in Medicare PECOS and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1710236799

Entity TypeIndividualFemale

Primary Taxonomy122300000X

Provider Legal NameKIMBERLY WALTERSCredential: DMD

Location Address701 PARK AVENUE SOUTHMinneapolis, MN 55415

Mailing Address8088 W Whitney DrPeoria, AZ 85345-6564 · (602) 344-5287

Phone(612) 873-3000

Sole ProprietorNo

Enumeration DateSeptember 5, 2012

Last NPPES UpdateAugust 20, 20263 updates tracked since enumeration

NPPES CertifiedAugust 20, 2026

✔ NPI 1710236799 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDentistDental Providers

Taxonomy Code122300000X

Licenses✔ Licensed in AZ · D008447✔ Licensed in OR · D10041

Definition

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

Also ListedDentist · General PracticeTaxonomy 1223G0001X · License 61829 (CA)

701 PARK AVENUE SOUTH, Minneapolis, MN 55415

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Secondary Practice Locations 2

Location 11705 W Main StMesa, AZ 85201-6920 · Phone (480) 247-7303

Location 22525 E Roosevelt StPhoenix, AZ 85008-4948 · Phone (833) 855-9973

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter Health, Anthem Blue Cross and Blue Shield and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kimberly Walters Dmd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Kimberly Walters reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Maricopa County Special Health Care District

1,270 mi

Adult Mental Health

950 E MAIN ST
Mesa, AZ 85203

Reassigned Medicare billing, Arizona enrollment
285 clinicians in this Medicare group

NPI 1104331115 (602) 655-6260

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55415 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$85.82 typical visit price

range $56.00 – $168.28

Typical copayment $21.45 (range $14.00 – $42.07)

Most-billed visit code 99203

Established Patient

$69.74 typical visit price

range $18.32 – $138.04

Typical copayment $17.43 (range $4.58 – $34.51)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ISSAC GEORGY MBBS