Provider Demographics
NPI:1265530927
Name:W.R. WHITLOW, D.D.S., PA
Entity type:Organization
Organization Name:W.R. WHITLOW, D.D.S., PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:R
Authorized Official - Last Name:WHITLOW
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:620-663-1141
Mailing Address - Street 1:2301 N WALDRON ST
Mailing Address - Street 2:
Mailing Address - City:HUTCHINSON
Mailing Address - State:KS
Mailing Address - Zip Code:67502-1133
Mailing Address - Country:US
Mailing Address - Phone:620-663-1141
Mailing Address - Fax:620-663-1373
Practice Address - Street 1:1919 N MAIZE RD STE 200
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67212-5203
Practice Address - Country:US
Practice Address - Phone:316-721-4890
Practice Address - Fax:316-721-1529
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:W.R. WHITLOW, D.D.S., PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-09-20
Last Update Date:2007-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS64231223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS022839OtherBLUE CROSS & BLUE SHIELD
KS022839OtherBLUE CROSS & BLUE SHIELD
KST44090Medicare UPIN