Provider Demographics
NPI:1225136427
Name:JUMPER, MARK WHITNEY II (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:WHITNEY
Last Name:JUMPER
Suffix:II
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 1:1614 E RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78741-1006
Mailing Address - Country:US
Mailing Address - Phone:512-707-7300
Mailing Address - Fax:512-707-7302
Practice Address - Street 1:1614 E RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78741-1006
Practice Address - Country:US
Practice Address - Phone:512-707-7300
Practice Address - Fax:512-707-7302
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2011-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR35931223G0001X
TX231741223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice