Provider Demographics
NPI:1982263463
Name:WHINERY, GRAHAM (DDS)
Entity Type:Individual
Prefix:
First Name:GRAHAM
Middle Name:
Last Name:WHINERY
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 1:4 OAK RUN ST
Mailing Address - Street 2:
Mailing Address - City:WHITE OAK
Mailing Address - State:TX
Mailing Address - Zip Code:75693-1558
Mailing Address - Country:US
Mailing Address - Phone:817-888-0640
Mailing Address - Fax:
Practice Address - Street 1:908 HIGHWAY 37
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:TX
Practice Address - Zip Code:75457-4500
Practice Address - Country:US
Practice Address - Phone:817-888-0640
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-10
Last Update Date:2020-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX359041223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice