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NPI Code Detail

MEDICARE: DR. JOHN JAMES WHITEHEAD D.D.S.

MEDICARE:  DR. JOHN JAMES WHITEHEAD  D.D.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist23158CA

General Provider Information

NPI Number : 1093949414
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHN JAMES WHITEHEAD D.D.S.
Provider Business Mailing Address
First Line : 3162 NEWBERRY DR
Second Line :
City : SAN JOSE
State : CA
Zip : 95118-1500
Country : US
Telephone Number : 408-274-9600
Fax Number :
Provider Business Practice Location Address
First Line : 3162 NEWBERRY DR
Second Line :
City : SAN JOSE
State : CA
Zip : 95118-1500
Country : US
Telephone Number : 408-274-9600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/13/2009
Last Update Date : 05/13/2009

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Directions to “ DR. JOHN JAMES WHITEHEAD D.D.S.” Practice Location

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