Provider Demographics
NPI:1356984447
Name:DR DIANNE WHITFIELD-LOCKE'S DENTAL
Entity type:Organization
Organization Name:DR DIANNE WHITFIELD-LOCKE'S DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LAKEETHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMMOND MCDONALD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-420-1464
Mailing Address - Street 1:5105 MARLBORO PIKE
Mailing Address - Street 2:
Mailing Address - City:CAPITOL HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:20743-5402
Mailing Address - Country:US
Mailing Address - Phone:301-420-1464
Mailing Address - Fax:301-735-0056
Practice Address - Street 1:5105 MARLBORO PIKE
Practice Address - Street 2:
Practice Address - City:CAPITOL HEIGHTS
Practice Address - State:MD
Practice Address - Zip Code:20743-5402
Practice Address - Country:US
Practice Address - Phone:301-420-1464
Practice Address - Fax:301-735-0056
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-22
Last Update Date:2019-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDentalGroup - Multi-Specialty