Provider Demographics
NPI:1285272906
Name:JAMES V. WHALEN DMD LTD.
Entity type:Organization
Organization Name:JAMES V. WHALEN DMD LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:WHALEN
Authorized Official - Suffix:
Authorized Official - Credentials:RDH
Authorized Official - Phone:702-255-2111
Mailing Address - Street 1:9450 DEL WEBB BLVD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89134-8314
Mailing Address - Country:US
Mailing Address - Phone:702-255-2111
Mailing Address - Fax:702-255-8075
Practice Address - Street 1:9450 DEL WEBB BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89134-8314
Practice Address - Country:US
Practice Address - Phone:702-255-2111
Practice Address - Fax:702-255-8075
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JAMES V. WHALEN DMD LTD.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-12-12
Last Update Date:2019-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty