Provider Demographics
NPI:1568490456
Name:WHISTON, DAVID A (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:A
Last Name:WHISTON
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 1:6400 ARLINGTON BLVD
Mailing Address - Street 2:PLAZA 1, LOBBY LEVEL
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22042-2325
Mailing Address - Country:US
Mailing Address - Phone:703-534-6500
Mailing Address - Fax:703-534-0039
Practice Address - Street 1:6400 ARLINGTON BLVD
Practice Address - Street 2:PLAZA 1, LOBBY LEVEL
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22042-2325
Practice Address - Country:US
Practice Address - Phone:703-534-6500
Practice Address - Fax:703-534-0039
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010034441223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA179471Medicare ID - Type Unspecified
VAT31015Medicare UPIN