Provider Demographics
NPI:1982633848
Name:JAMES A WHITLEY, DDS PA
Entity Type:Organization
Organization Name:JAMES A WHITLEY, DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ARTHUR
Authorized Official - Last Name:WHITLEY
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:919-789-0400
Mailing Address - Street 1:309 W MILLBROOK RD
Mailing Address - Street 2:SUITE 181
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-4385
Mailing Address - Country:US
Mailing Address - Phone:919-789-0400
Mailing Address - Fax:919-789-0440
Practice Address - Street 1:309 W MILLBROOK RD
Practice Address - Street 2:SUITE 181
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-4385
Practice Address - Country:US
Practice Address - Phone:919-789-0400
Practice Address - Fax:919-789-0440
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNC 54301223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5430OtherSTATE LICENSE NUMBER
NC99245OtherBCBSNC IDENTIFIER