17TH STREET MODERN DENTISTRY DENTAL GROUP
NPI 1790273829
Dentist in Costa Mesa, CA

Q: What is Clint Walker Dental Corporation's NPI number?

The NPI number for Clint Walker Dental Corporation is 1790273829. It was assigned to this organization in the NPPES registry on April 24, 2018. The provider is doing business as 17th Street Modern Dentistry Dental Group.

Q: What is Clint Walker Dental Corporation's specialty?

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

Active since April 24, 2018

270 E 17TH ST STE 15, COSTA MESA, CA 92627(714) 224-0480(714) 224-0480 Get Directions Write a Review

NPPES record last updated: May 11, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 11, 2022, Apr 24, 2018 (2 updates tracked since 2018).

On this page

About 17th Street Modern Dentistry Dental Group NPPES

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

17TH STREET MODERN DENTISTRY DENTAL GROUP (NPI 1790273829) is a healthcare organization registered as a dentist in Costa Mesa, California and active in the NPI registry since April 2018. The organization lists Clint Walker, Owner, as its authorized official.

NPPES Registry Identity

NPI1790273829

Entity TypeOrganization

Primary Taxonomy122300000X

Legal Business NameCLINT WALKER DENTAL CORPORATION

Location Address270 E 17TH ST STE 15Costa Mesa, CA 92627-3845

Mailing AddressPo Box 920050Dallas, TX 75392-0050

Phone(714) 224-0480

Fax(714) 224-0480

Organization SubpartNo

Authorized OfficialClint WalkerOwner · (714) 224-0480

Enumeration DateApril 24, 2018

Last NPPES UpdateMay 11, 20222 updates tracked since enumeration

NPPES CertifiedMay 11, 2022

✔ NPI 1790273829 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers

Taxonomy Code122300000X

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.

270 E 17TH ST STE 15, Costa Mesa, CA 92627

Open in Google Maps ↗

Other Names 1

Doing Business As17th Street Modern Dentistry Dental Group

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 5

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

GABRIELLE JANNOTTA

Dentist