Provider Demographics
NPI:1467665612
Name:WHITNEY, MEGAN A (DMD)
Entity Type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:A
Last Name:WHITNEY
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 DAY STREET
Mailing Address - Street 2:NORWALK SMILES CHC, INC
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06854
Mailing Address - Country:US
Mailing Address - Phone:203-854-9292
Mailing Address - Fax:
Practice Address - Street 1:49 DAY STREET
Practice Address - Street 2:NORWALK SMILES CHC, INC
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06854
Practice Address - Country:US
Practice Address - Phone:203-854-9292
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2012-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0103531223G0001X
NY0529601223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No1223P0300XDental ProvidersDentistPeriodontics