JACK A. WHITTAKER D.D.S., INC. (NPI# 1851564579) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851564579 |
| Entity Type | Organization |
| Organization Name | JACK A. WHITTAKER D.D.S., INC. |
| Practice Address |
960 W Wooster St Suite 201 Bowling Green OH 43402-2644 |
| Practice Telephone | 4193523527 |
| Practice Fax Number | 4193526122 |
| Mailing Telephone | 4193523527 |
| Mailing Fax Number | 4193526122 |
| Enumeration Date | 2008-04-03 |
| Last Update Date | 2008-04-03 |
| Authorized Official Name | DR. JACK ALLEN WHITTAKER (PEDIATRIC DENTIST) |
| Authorized Official Telephone | 4193523527 |
| Authorized Official Credential | D.D.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 30 012369 | OH | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 0017332 | 05 | |
| OH | DORAL DENTAL SERVICES | 7073 | 01 |
| OH | PARAMOUNT ADVANTAGE | 01928 | 01 |
| Street Address |
960 W WOOSTER ST SUITE 201 |
| City | BOWLING GREEN |
| State | OH |
| Zip Code | 43402-2644 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760489173 | Thurai Y Kumaran | Internal Medicine | 960 W Wooster St, Suite 205, Bowling Green, OH 43402-2644 | 2005-06-30 |
| 1093254542 | Ginger Lee Caris | Dietitian, Registered | 960 W Wooster St, Bowling Green, OH 43402-2644 | 2017-02-16 |
| 1225326283 | Laurie Sue Meyer | Nurse Practitioner | 960 W Wooster St, Suite 116, Bowling Green, OH 43402-2644 | 2011-07-12 |
| 1649435835 | Surgical Specialists of Bowling Green LLC | Surgery | 960 W Wooster St, Suite 202, Bowling Green, OH 43402-2644 | 2008-07-28 |
| 1356563985 | Bethany Gries | Dietitian, Registered | 960 W Wooster St, Suite 116, Bowling Green, OH 43402-2644 | 2007-05-03 |
| 1336279769 | Pinewood Family Practice Inc | Family Medicine | 960 W Wooster St, Suite 115, Bowling Green, OH 43402-2644 | 2007-03-06 |
| 1407908486 | Toledo Clinic Incorporated | Durable Medical Equipment & Medical Supplies | 960 W Wooster St, Suite 111, Bowling Green, OH 43402-2644 | 2007-01-18 |
| 1609935030 | Wood County Family Care Inc. | Family Medicine | 960 W Wooster St, Suite 202, Bowling Green, OH 43402-2644 | 2006-12-08 |
| 1639238629 | K Mahmood M D Inc | Psychiatry & Neurology | 960 W Wooster St, Suite 202, Bowling Green, OH 43402-2644 | 2006-12-06 |
| 1013083260 | Rogelio A. Sanchez, Md, Co, PC | Family Medicine | 960 W Wooster St, 106, Bowling Green, OH 43402-2644 | 2006-11-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316592017 | Danielle Urbaniak | Pharmacist | 722-740 South Main St, Bowling Green, OH 43402 | 2019-08-08 |
| 1013485648 | Julie Marie Knapp | Counselor | 219 South Church Street, Bowling Green, OH 43402 | 2018-11-13 |
| 1477065274 | Elizabeth Marie Leber | Social Worker | 1045 Klotz Rd., Bowling Green, OH 43402 | 2017-11-02 |
| 1558871913 | Genoa Healthcare, LLC | Pharmacy | 1010 N Prospect St Ste 56, Bowling Green, OH 43402 | 2017-10-11 |
| 1093224933 | Kevin Wagner | Contractor | 19644 Hull Prairie Rd, Bowling Green, OH 43402 | 2017-09-22 |
| 1487102273 | Mary Ann Bostdorff | Registered Nurse | 1011 North Prospect St., Bowling Green, OH 43402 | 2016-09-21 |
| 1174927354 | Kristy Siegle | Counselor | 1010 North Prospect, Bowling Green, OH 43402 | 2014-10-16 |
| 1366846560 | Timothy M Burkart | Pharmacist | 1840 E. Gypsy Lane Rd, (wood County Health Department), Bowling Green, OH 43402 | 2014-10-16 |
| 1144629411 | Ledeithra Denise Mckinney | Speech-Language Pathologist | 1921 East Gypsy Lane Rd., Bowling Green, OH 43402 | 2014-08-22 |
| 1558701607 | Mark Joseph Kleeberger | Physical Therapy Assistant | 1180 N Main St, Bowling Green, OH 43402 | 2013-07-02 |
| Find all providers in zip 43402 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356821441 | Shanna G. Burress, Dmd, Psc | Dentist | 2425 Scottsville Rd Ste 120, Bowling Green, KY 42104-4457 | 2018-08-17 |
| 1205364411 | Amanda Katherin Walden | Dentist | 725 A Kenton Street, Bowling Green, KY 42101 | 2017-06-01 |
| 1679947246 | Derek Hunter Hayes | Dentist | 1430 Jenny Ct, Bowling Green, KY 42103-4764 | 2015-11-19 |
| 1124409479 | Brittany Strawman | Dentist | 1457 Sand Ridge Rd, Bowling Green, OH 43402-4493 | 2015-06-12 |
| 1407286198 | Eastwood Dental Pllc | Dentist | 628 Eastwood St, Bowling Green, KY 42103-1602 | 2013-11-18 |
| 1932451267 | Kevin D. Daugherty | Dentist | 727 Us 31w Byp Ste 101, Bowling Green, KY 42101-4963 | 2012-10-10 |
| 1235443052 | Daniel Morgan Carter | Dentist | 1906 College Heights Blvd # 21038, Academic Complex Room 408, Bowling Green, KY 42101-1000 | 2010-08-04 |
| 1033326483 | John Willard Strawman V | Dentist | 1064 W Wooster St, Bowling Green, OH 43402-2633 | 2007-05-16 |
| 1154545630 | Oles B Drobocky | Dentist | 727 Us 31 W By Pass, Suite 113, Bowling Green, KY 42101 | 2007-04-13 |
| 1124142773 | Amanda Gaynor Ashley | Dentist | 234 Natchez Trace Ave, Bowling Green, KY 42103-7995 | 2007-03-19 |
| Find all providers in BOWLING GREEN | ||||
| City | BOWLING GREEN |
| Zip Code | 43402 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.