Provider Demographics
NPI:1639500879
Name:WHETMAN, JEREMIAH (DDS)
Entity type:Individual
Prefix:DR
First Name:JEREMIAH
Middle Name:
Last Name:WHETMAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5303 HAMILTON WOLFE RD
Mailing Address - Street 2:APT 401
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-4419
Mailing Address - Country:US
Mailing Address - Phone:402-599-3216
Mailing Address - Fax:
Practice Address - Street 1:5303 HAMILTON WOLFE RD
Practice Address - Street 2:APT 401
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-4419
Practice Address - Country:US
Practice Address - Phone:402-599-3216
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-12
Last Update Date:2013-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program