Provider Demographics
NPI:1417010430
Name:WHITNEY, JAMES HENDERSON SMITH (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:HENDERSON SMITH
Last Name:WHITNEY
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 1:9626 S CONGRESS ST
Mailing Address - Street 2:
Mailing Address - City:NEW MARKET
Mailing Address - State:VA
Mailing Address - Zip Code:22844-9450
Mailing Address - Country:US
Mailing Address - Phone:540-740-8937
Mailing Address - Fax:540-740-9227
Practice Address - Street 1:9626 S CONGRESS ST
Practice Address - Street 2:
Practice Address - City:NEW MARKET
Practice Address - State:VA
Practice Address - Zip Code:22844-9450
Practice Address - Country:US
Practice Address - Phone:540-740-8937
Practice Address - Fax:540-740-9227
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2020-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401005040204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
005337OtherANTHEM
380876OtherANTHEM
T21534Medicare UPIN
VA190000292Medicare ID - Type Unspecified