Provider Demographics
NPI:1417564923
Name:WHITNEY BEHM DMD, LLC
Entity Type:Organization
Organization Name:WHITNEY BEHM DMD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WHITNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:BEHM
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:815-219-8699
Mailing Address - Street 1:232 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:IL
Mailing Address - Zip Code:60098-3214
Mailing Address - Country:US
Mailing Address - Phone:815-337-1932
Mailing Address - Fax:
Practice Address - Street 1:232 MAIN ST
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:IL
Practice Address - Zip Code:60098-3214
Practice Address - Country:US
Practice Address - Phone:815-337-1932
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-29
Last Update Date:2020-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental