Provider Demographics
NPI:1982807145
Name:WHITING, JAMES BRUCE (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:BRUCE
Last Name:WHITING
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 1:218 TOPONCE DR
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:WY
Mailing Address - Zip Code:82930-5614
Mailing Address - Country:US
Mailing Address - Phone:307-789-2301
Mailing Address - Fax:
Practice Address - Street 1:831 STATE HIGHWAY 150 S
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:WY
Practice Address - Zip Code:82930-5340
Practice Address - Country:US
Practice Address - Phone:307-789-3464
Practice Address - Fax:307-789-7373
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY5181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice