Provider Demographics
NPI:1407921463
Name:WHITMAN, RICHARD JAMES (DDS)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:JAMES
Last Name:WHITMAN
Suffix:
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 1:900 S 74TH PLZ
Mailing Address - Street 2:SUITE 300
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-4667
Mailing Address - Country:US
Mailing Address - Phone:402-884-1002
Mailing Address - Fax:402-905-2434
Practice Address - Street 1:900 S 74TH PLZ
Practice Address - Street 2:SUITE 300
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-4667
Practice Address - Country:US
Practice Address - Phone:402-884-1002
Practice Address - Fax:402-905-2434
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-22
Last Update Date:2011-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE44741223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice