Provider Demographics
NPI:1326232737
Name:DR. JOHN R. WHELESS III, DDS
Entity Type:Organization
Organization Name:DR. JOHN R. WHELESS III, DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:B
Authorized Official - Last Name:WHELESS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:276-632-3151
Mailing Address - Street 1:311 BROWN ST
Mailing Address - Street 2:
Mailing Address - City:MARTINSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24112-3801
Mailing Address - Country:US
Mailing Address - Phone:276-632-3151
Mailing Address - Fax:276-632-6456
Practice Address - Street 1:311 BROWN ST
Practice Address - Street 2:
Practice Address - City:MARTINSVILLE
Practice Address - State:VA
Practice Address - Zip Code:24112-3801
Practice Address - Country:US
Practice Address - Phone:276-632-3151
Practice Address - Fax:276-632-6456
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-29
Last Update Date:2007-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty