Individual provider Active NPI

Raymond Joseph Whittingham, D.D.S.

  • General Practice Dentistry
  • Frankfort, IL
National Provider Identifier
1093904583
Registry record updated Oct 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Practice address
330 W Lincoln Hwy
Frankfort, IL 60423-1289
Phone
(815) 469-3900
Fax
(815) 469-2661
NPI assigned
Oct 19, 2007
Last updated
Oct 19, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 19, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X IL Primary

Addresses

Primary practice location

330 W Lincoln Hwy
Frankfort, IL 60423-1289

Mailing address

330 W Lincoln Hwy
Frankfort, IL 60423-1289
Phone (815) 469-3900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150701000558 IL Order and Referring Only - DentistPractitioner - Dentist 7012229248

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1192752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192752000000",
    "number": "1093904583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 W LINCOLN HWY",
            "city": "FRANKFORT",
            "state": "IL",
            "postal_code": "604231289",
            "telephone_number": "815-469-3900",
            "fax_number": "815-469-2661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 W LINCOLN HWY",
            "city": "FRANKFORT",
            "state": "IL",
            "postal_code": "604231289",
            "telephone_number": "815-469-3900",
            "fax_number": "815-469-2661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITTINGHAM",
        "first_name": "RAYMOND",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-10-19",
        "last_updated": "2007-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frankfort, IL

Sources for this page

Verify at the official NPI Registry.