Active NPI
Daniel Whitley III, DDS
- General Practice Dentistry
- Jacksonville, NC
National Provider Identifier
1184039455
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 9763
- Practice address
- 200 Doctors Dr
Jacksonville, NC 28546-6310 - Phone
- (910) 353-4242
- NPI assigned
- Jun 25, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 9763 | NC | Primary |
Addresses
Primary practice location
200 Doctors Dr
Jacksonville, NC 28546-6310
Mailing address
311 Pineland Dr
Goldsboro, NC 27534-1717
Phone (919) 457-6489
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9763 | NC | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1403654400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1470614400000",
"number": "1184039455",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "311 PINELAND DR",
"city": "GOLDSBORO",
"state": "NC",
"postal_code": "275341717",
"telephone_number": "919-457-6489"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 DOCTORS DR",
"city": "JACKSONVILLE",
"state": "NC",
"postal_code": "285466310",
"telephone_number": "910-353-4242"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITLEY",
"first_name": "DANIEL",
"name_prefix": "Dr.",
"name_suffix": "III",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-06-25",
"last_updated": "2016-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NC",
"license": "9763",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.