Provider Demographics
NPI:1710656970
Name:WHITWORTH, DENNIS JAMES (PHARMD)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:JAMES
Last Name:WHITWORTH
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:406 N STATE STREET
Mailing Address - Street 2:ADDRESS LINE 2
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84057
Mailing Address - Country:US
Mailing Address - Phone:801-434-7670
Mailing Address - Fax:
Practice Address - Street 1:406 NORTH STATE STREET
Practice Address - Street 2:ADDRESS LINE 2
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84057
Practice Address - Country:US
Practice Address - Phone:801-434-7670
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-10
Last Update Date:2021-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8089566-8911183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist