Todd Mitchell Whitlock, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12009170A Issued in IN

Practice address

3671 S Sare Rd
Bloomington, IN 47401-4173

Phone

(812) 332-0052

Fax

(812) 332-0128

NPI assigned

Sep 26, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Todd Whitlock, DDS, LLC

  • General Practice Dentistry
  • Bloomington, IN
  • NPI 1881843613
  NPD (past) Authorized official

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329436800000",
    "number": "1205937943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3671 S SARE RD",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474014173",
            "telephone_number": "812-332-0052",
            "fax_number": "812-332-0128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3671 S SARE RD",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474014173",
            "telephone_number": "812-332-0052",
            "fax_number": "812-332-0128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITLOCK",
        "first_name": "TODD",
        "middle_name": "MITCHELL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2012-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12009170A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Lynn White, AU.D.
• Maelynn White
• Ronald Lemond White, M.D.
• Paige Whitesell
• Jennifer Whitley
• Kelly Whitney-Babcock, A.T.C., L.A.T.
• Kegahn Whyte, RBT
• Hayley Rose Wible, D.O.
• Jonathan Wicks, ATC, LAT, M.ED
• Otto William Wickstrom III, M.D.

• General Practice Dentistry in Bloomington, IN
• Providers in Bloomington, IN by specialty
• General Practice Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2012; 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.