1891902565 NPI number — JOHNWHITMAN,DDS/WAYNENAQUIN,DDS/APDC

Table of content: (NPI 1891902565)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891902565 NPI number — JOHNWHITMAN,DDS/WAYNENAQUIN,DDS/APDC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JOHNWHITMAN,DDS/WAYNENAQUIN,DDS/APDC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1891902565
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/17/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9283 PARK AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOUMA
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70363-3787
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
985-876-3532
Provider Business Mailing Address Fax Number:
985-876-3533

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9283 PARK AVENUE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOUMA
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70363-3787
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
985-876-3532
Provider Business Practice Location Address Fax Number:
985-876-3533
Provider Enumeration Date:
05/16/2007

Additional Information

Authorized Official

Authorized Official Last Name:
WHITMAN
Authorized Official First Name:
JOHN
Authorized Official Middle Name:
FRANCIS
Authorized Official Title or Position:
DENTIST
Authorized Official Telephone Number:
985-876-3532

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  2776 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 1223G0001X , with the licence number: 2598 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com