Provider Demographics
NPI:1366465411
Name:WHITEHOUSE, JOSEPH ALAN (DDS)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:ALAN
Last Name:WHITEHOUSE
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 1:3603 JAMISON WAY
Mailing Address - Street 2:
Mailing Address - City:CASTRO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94546-4303
Mailing Address - Country:US
Mailing Address - Phone:510-881-1924
Mailing Address - Fax:510-537-3404
Practice Address - Street 1:3603 JAMISON WAY
Practice Address - Street 2:
Practice Address - City:CASTRO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94546-4303
Practice Address - Country:US
Practice Address - Phone:510-881-1924
Practice Address - Fax:510-537-3404
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23772122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA23772OtherSTATE LICENSE NUMBER