Daniel Robert Whittaker, D.M.D.
Individual provider Active NPI General Practice Dentistry · Bryan, OH
NPI 1396948899 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1396948899
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 22540 (OH)
- Practice address
- 201 Van Gundy Dr
BLDG a
Bryan, OH 43506-1178 - Phone
- (419) 636-4202
- Fax
- (419) 363-6976
- NPI assigned
- Jun 11, 2007
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
- Opted out of Medicare
- Yes, effective Jun 24, 2015 through Jun 24, 2027
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22540 | OH | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Daniel Whittaker R DMD, Inc. | Past | Accepting new patients | |
| DRS. Hanna and Phillips D.D.S. and Associates, Inc. | General Practice | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 22540 | OH | Yes |
Addresses
Primary practice location
201 Van Gundy Dr
BLDG a
Bryan, OH 43506-1178
Mailing address
201 Van Gundy Dr
BLDG a
Bryan, OH 43506-1178
Phone (419) 636-4202
Other providers in Bryan, OH
- Jennifer J Weber
- Ashley Weirauch
- Kirtina Spengler West
- Hannah Wey
- Abbey Lee Whitney
- Jennifer L. Wieland
- Williams County Commissioners
- Williams County Office of Auditor
- Williams County Office of Auditor
- Williams County Transport
All providers in Bryan, OH · General Practice Dentistry in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.