Provider Demographics
NPI:1740244946
Name:WHITTEMORE, STEVEN DARCEY (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:DARCEY
Last Name:WHITTEMORE
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 1:4535 ZILKER DR
Mailing Address - Street 2:
Mailing Address - City:PLEASANT HILL
Mailing Address - State:IA
Mailing Address - Zip Code:50327-0923
Mailing Address - Country:US
Mailing Address - Phone:515-262-5129
Mailing Address - Fax:
Practice Address - Street 1:1000 73RD ST
Practice Address - Street 2:SUITE 10
Practice Address - City:WINDSOR HEIGHTS
Practice Address - State:IA
Practice Address - Zip Code:50311-1321
Practice Address - Country:US
Practice Address - Phone:515-223-1298
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA082281223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1463562Medicaid