Provider Demographics
NPI:1306189295
Name:WHITTINGTON, RONALD DEAN (DMD)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:DEAN
Last Name:WHITTINGTON
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 QUAIL CREEK DR UNIT A
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79124-1637
Mailing Address - Country:US
Mailing Address - Phone:806-359-1212
Mailing Address - Fax:806-354-9552
Practice Address - Street 1:500 QUAIL CREEK DR UNIT A
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79124-1637
Practice Address - Country:US
Practice Address - Phone:806-359-1212
Practice Address - Fax:806-354-9552
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-29
Last Update Date:2013-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10239122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist