Provider Demographics
NPI:1225240070
Name:TIPPETT-WHYTE, JUDEE A (DDS)
Entity Type:Individual
Prefix:DR
First Name:JUDEE
Middle Name:A
Last Name:TIPPETT-WHYTE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4534 PRECISSI LN STE A
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95207-6213
Mailing Address - Country:US
Mailing Address - Phone:209-957-8940
Mailing Address - Fax:209-957-7990
Practice Address - Street 1:4534 PRECISSI LN STE A
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95207-6213
Practice Address - Country:US
Practice Address - Phone:209-957-8940
Practice Address - Fax:209-957-7990
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA0347831223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice