Diana Jenny Whittaker, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

20834 Issued in MI

Practice address

25630 Little Mack Ave Ste 1
Saint Clair Shores, MI 48081-2109

Phone

(586) 285-5758

NPI assigned

Jun 12, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Diana J Lemire Former name

Medicare fee-for-service enrollment

Enrolled in MI

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Diana Whittaker DDS PLC

  • Dental Clinic/Center
  • Saint Clair Shores, MI
  • NPI 1801623616
  NPD Authorized official
• Summit Dental Associates

  • General Practice Dentistry
  • Omaha, NE
  • NPI 1073783445
  NPD (past)
• Summit Dental Health - Center LLC

  • General Practice Dentistry
  • Omaha, NE
  • NPI 1275941734
  NPD (past)

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

{
    "created_epoch": "1339459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726444800000",
    "number": "1598027088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25630 LITTLE MACK AVE STE 1",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480812109",
            "telephone_number": "586-285-5758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25630 LITTLE MACK AVE STE 1",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480812109",
            "telephone_number": "586-285-5758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITTAKER",
        "first_name": "DIANA",
        "middle_name": "JENNY",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-12",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "20834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIANA",
            "last_name": "LEMIRE",
            "middle_name": "J",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kristen Esther White, AGPCNP-BC
• Lakora Renee White
• Nathan S. White, MD
• Nicole Leigh White
• Bradford A. Whitmer, D.O.
• Rebecca Wideman, FNP-C
• Wigs 4 Kids
• Genna Wilkie, OTR/L
• Scott Wilkinson, DO
• Blair Allen Willard, RPH

• General Practice Dentistry in Saint Clair Shores, MI
• Providers in Saint Clair Shores, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.