Provider Demographics
NPI:1598865198
Name:WHITING, SIDNEY NIEL (DDS)
Entity Type:Individual
Prefix:DR
First Name:SIDNEY
Middle Name:NIEL
Last Name:WHITING
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 1:990 PARADISE RD
Mailing Address - Street 2:STE 3B
Mailing Address - City:SWAMPSCOTT
Mailing Address - State:MA
Mailing Address - Zip Code:01909-1309
Mailing Address - Country:US
Mailing Address - Phone:781-595-0596
Mailing Address - Fax:781-581-9115
Practice Address - Street 1:990 PARADISE RD
Practice Address - Street 2:STE 3B
Practice Address - City:SWAMPSCOTT
Practice Address - State:MA
Practice Address - Zip Code:01909-1309
Practice Address - Country:US
Practice Address - Phone:781-595-0596
Practice Address - Fax:781-581-9115
Is Sole Proprietor?:No
Enumeration Date:2006-09-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA112561223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice