Provider Demographics
NPI:1215116868
Name:WHITTEN, KARRY K (DDS)
Entity type:Individual
Prefix:DR
First Name:KARRY
Middle Name:K
Last Name:WHITTEN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10020 NICHOLAS ST STE 200
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-2188
Mailing Address - Country:US
Mailing Address - Phone:402-392-2880
Mailing Address - Fax:402-392-0729
Practice Address - Street 1:10020 NICHOLAS ST STE 200
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-2188
Practice Address - Country:US
Practice Address - Phone:402-392-2880
Practice Address - Fax:402-392-0729
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-31
Last Update Date:2007-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE6138122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist