NPIMap

Organization Active NPI

Whitaker Family Dentistry, Inc.

  • General Practice Dentistry
  • Fort Valley, GA
National Provider Identifier
1063650562
Registry record updated Jul 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
10256 Issued in GA
Legal business name
WHITAKER FAMILY DENTISTRY, INC.
Practice address
906 Orange St
Fort Valley, GA 31030-3456
Phone
(478) 825-2001
NPI assigned
Jan 22, 2009
Last updated
Jul 8, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
John G Whitaker III
Title
Owner/ Dentist
Phone
(478) 825-2001

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 10256 GA Primary

Addresses

Primary practice location

906 Orange St
Fort Valley, GA 31030-3456

Mailing address

906 Orange St
Fort Valley, GA 31030-3456
Phone (478) 825-2001

Other practice location 1

607 Bluebird Blvd
Fort Valley, GA 31030-5082
Phone (478) 825-2314

National Provider Directory

National Provider Directory

Locations

906 Orange St
Fort Valley, GA 31030
Phone (478) 825-2001

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1232582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625702400000",
    "number": "1063650562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "906 ORANGE ST",
            "city": "FORT VALLEY",
            "state": "GA",
            "postal_code": "310303456",
            "telephone_number": "478-825-2001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "906 ORANGE ST",
            "city": "FORT VALLEY",
            "state": "GA",
            "postal_code": "310303456",
            "telephone_number": "478-825-2001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "607 Bluebird Blvd",
            "address_purpose": "LOCATION",
            "city": "Fort Valley",
            "state": "GA",
            "postal_code": "310305082",
            "country_code": "US",
            "telephone_number": "478-825-2314",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "WHITAKER FAMILY DENTISTRY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-22",
        "last_updated": "2021-07-08",
        "certification_date": "2021-07-08",
        "status": "A",
        "authorized_official_last_name": "WHITAKER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER/ DENTIST",
        "authorized_official_telephone_number": "478-825-2001",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "10256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Valley, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.