Eb Whillock DDS, LTD.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

M-347 Issued in SD

Legal business name

EB WHILLOCK DDS, LTD.

Practice address

804 West Blvd
Rapid City, SD 57701-3577

Phone

(605) 348-2040

Fax

(605) 348-6712

NPI assigned

Mar 15, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Edward Boyd Whillock, DDSNPI 1750423166

Title

Periodontist

Phone

(605) 348-2040

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Edward Boyd Whillock, DDS

  • Periodontics
  • Rapid City, SD
  • NPI 1750423166
  NPD (past) Authorized official

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1942334727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 WEST BLVD",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577013577",
            "telephone_number": "605-348-2040",
            "fax_number": "605-348-6712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 WEST BLVD",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577013577",
            "telephone_number": "605-348-2040",
            "fax_number": "605-348-6712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EB WHILLOCK DDS, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WHILLOCK",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "BOYD",
        "authorized_official_title_or_position": "PERIODONTIST",
        "authorized_official_telephone_number": "605-348-2040",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "SD",
            "license": "M-347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Periodontics in Rapid City, SD
• Providers in Rapid City, SD by specialty
• Periodontics in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.