Provider Demographics
NPI:1962468801
Name:MICHAEL F. WHELAN, MD, DDS, P.C.
Entity Type:Organization
Organization Name:MICHAEL F. WHELAN, MD, DDS, P.C.
Other - Org Name:SOUND SURGERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:F
Authorized Official - Last Name:WHELAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD, DDS
Authorized Official - Phone:425-778-5991
Mailing Address - Street 1:19625 68TH AVE W
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98036-5909
Mailing Address - Country:US
Mailing Address - Phone:425-778-5991
Mailing Address - Fax:
Practice Address - Street 1:19625 68TH AVE W
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-5909
Practice Address - Country:US
Practice Address - Phone:425-778-5991
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000082811223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG74484Medicare UPIN