Provider Demographics
NPI:1477977940
Name:TARKINGTON, WHITNEY (RDH)
Entity Type:Individual
Prefix:
First Name:WHITNEY
Middle Name:
Last Name:TARKINGTON
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99114B FOREST DR
Mailing Address - Street 2:
Mailing Address - City:FORT DRUM
Mailing Address - State:NY
Mailing Address - Zip Code:13603-3415
Mailing Address - Country:US
Mailing Address - Phone:256-605-3849
Mailing Address - Fax:
Practice Address - Street 1:99114B FOREST DR
Practice Address - Street 2:
Practice Address - City:FORT DRUM
Practice Address - State:NY
Practice Address - Zip Code:13603-3415
Practice Address - Country:US
Practice Address - Phone:256-605-3849
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-04
Last Update Date:2014-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027403-1124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist