Provider Demographics
NPI:1093965626
Name:WHITFIELD, HEATH AUSTIN (DDS)
Entity Type:Individual
Prefix:DR
First Name:HEATH
Middle Name:AUSTIN
Last Name:WHITFIELD
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3824 S BOULEVARD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-5778
Mailing Address - Country:US
Mailing Address - Phone:405-513-8811
Mailing Address - Fax:405-513-7083
Practice Address - Street 1:3824 S BOULEVARD
Practice Address - Street 2:SUITE 110
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-5778
Practice Address - Country:US
Practice Address - Phone:405-513-8811
Practice Address - Fax:405-513-7083
Is Sole Proprietor?:No
Enumeration Date:2008-09-18
Last Update Date:2011-08-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK831223P0221X
OK60481223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No1223G0001XDental ProvidersDentistGeneral Practice