Provider Demographics
NPI:1427207893
Name:CHANTAL G. WHITNEY, DDS, INC.
Entity Type:Organization
Organization Name:CHANTAL G. WHITNEY, DDS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHANTAL
Authorized Official - Middle Name:G
Authorized Official - Last Name:WHITNEY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:216-464-1169
Mailing Address - Street 1:3401 RICHMOND ROAD
Mailing Address - Street 2:SUITE 230
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122
Mailing Address - Country:US
Mailing Address - Phone:216-464-1169
Mailing Address - Fax:216-464-1869
Practice Address - Street 1:3401 RICHMOND ROAD
Practice Address - Street 2:SUITE 230
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122
Practice Address - Country:US
Practice Address - Phone:216-464-1169
Practice Address - Fax:216-464-1869
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-10
Last Update Date:2008-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-01-4834122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty