Provider Demographics
NPI:1003938416
Name:WHITAKER, AARON TYRONE (DDS)
Entity Type:Individual
Prefix:DR
First Name:AARON
Middle Name:TYRONE
Last Name:WHITAKER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:529 FLORIDA AVE NW # 2
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20001-1850
Mailing Address - Country:US
Mailing Address - Phone:202-232-2960
Mailing Address - Fax:202-232-6000
Practice Address - Street 1:529 FLORIDA AVE NW # 2
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20001-1850
Practice Address - Country:US
Practice Address - Phone:202-232-2960
Practice Address - Fax:202-232-6000
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC0043891223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC004389OtherLICENSE #