Jesse R Whitely, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

59369 Issued in CA

Practice address

3113 Professional Dr Ste 1
Auburn, CA 95603-2459

Phone

(530) 885-6559

NPI assigned

Jul 14, 2010

Sex

Male

Sole proprietor

No

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

Enrolled in OR

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.

• Jesse Whitely DDS, Inc

  • Dental Clinic/Center
  • Auburn, CA
  • NPI 1972081545
  NPD Authorized official

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

{
    "created_epoch": "1279065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640217600000",
    "number": "1720391162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3113 PROFESSIONAL DR STE 1",
            "city": "AUBURN",
            "state": "CA",
            "postal_code": "956032459",
            "telephone_number": "530-885-6559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3113 PROFESSIONAL DR STE 1",
            "city": "AUBURN",
            "state": "CA",
            "postal_code": "956032459",
            "telephone_number": "530-885-6559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITELY",
        "first_name": "JESSE",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-14",
        "last_updated": "2021-12-23",
        "certification_date": "2021-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "59369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Western Sierra Medical Clinic, Inc.
• Western Sierra Medical Clinic, Inc. (Western Sierra Medical Clinic)
• Michelle Marie Whalley, PHARM.D.
• Amanda White, R.D.H.
• Karrie White
• Janice S. Whiteside, RN
• Bryce J Whitesides, PHARMD
• Marques P Whitfield, RADT
• Diane Whiting, LVN
• Mikayla Marie Whiting

• General Practice Dentistry in Auburn, CA
• Providers in Auburn, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2021; 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.