Provider Demographics
NPI:1841605722
Name:GWALTNEY, WHITNEY BAILEY (DDS)
Entity Type:Individual
Prefix:DR
First Name:WHITNEY
Middle Name:BAILEY
Last Name:GWALTNEY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:WHITNEY
Other - Middle Name:ANN
Other - Last Name:BAILEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:2486 PRUDEN BLVD.
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23434
Mailing Address - Country:US
Mailing Address - Phone:757-539-3021
Mailing Address - Fax:757-539-6262
Practice Address - Street 1:2486 PRUDEN BLVD.
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23434
Practice Address - Country:US
Practice Address - Phone:757-539-3021
Practice Address - Fax:757-539-6262
Is Sole Proprietor?:No
Enumeration Date:2014-06-30
Last Update Date:2019-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC150980122300000X
VA0401414957122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist