Provider Demographics
NPI:1023409463
Name:WHELAN LOK DDS, INC
Entity type:Organization
Organization Name:WHELAN LOK DDS, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MISS
Authorized Official - First Name:VERONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTILLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-444-4220
Mailing Address - Street 1:10050 GARVEY AVE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:EL MONTE
Mailing Address - State:CA
Mailing Address - Zip Code:91733-2089
Mailing Address - Country:US
Mailing Address - Phone:626-444-4220
Mailing Address - Fax:626-444-6770
Practice Address - Street 1:10050 GARVEY AVE
Practice Address - Street 2:SUITE 105
Practice Address - City:EL MONTE
Practice Address - State:CA
Practice Address - Zip Code:91733-2088
Practice Address - Country:US
Practice Address - Phone:626-444-4220
Practice Address - Fax:626-444-6770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-06
Last Update Date:2015-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG93815-01OtherDENTI-CAL