Provider Demographics
NPI:1730300401
Name:JOSEPH A. WHITEHOUSE, M.S., D.D.S., INC
Entity Type:Organization
Organization Name:JOSEPH A. WHITEHOUSE, M.S., D.D.S., INC
Other - Org Name:CASTRO VALLEY DENTAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST, OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:WHITEHOUSE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:510-881-1924
Mailing Address - Street 1:3603 JAMISON WAY
Mailing Address - Street 2:
Mailing Address - City:CASTRO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94546-4303
Mailing Address - Country:US
Mailing Address - Phone:510-881-1924
Mailing Address - Fax:
Practice Address - Street 1:3603 JAMISON WAY
Practice Address - Street 2:
Practice Address - City:CASTRO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94546-4303
Practice Address - Country:US
Practice Address - Phone:510-881-1924
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-01
Last Update Date:2008-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23772122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty