MEDICARE: WHITING ORTHODONTICS PLLC

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
1	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry

General Provider Information

NPI Number	:	1225874340
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WHITING ORTHODONTICS PLLC

Provider Business Mailing Address
First Line	:	600 SIGNAL PEAK ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89138-1600
Country	:	US
Telephone Number	:	702-845-4934
Fax Number	:

Provider Business Practice Location Address
First Line	:	6620 SKY POINTE DR STE 100
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89131-4001
Country	:	US
Telephone Number	:	702-550-8827
Fax Number	:

Authorized Official
Title or Position	:	OWNER/MANAGER
Name	:	DR. MARK WHITING
Credential	:
Telephone Number	:	702-845-4934

Provider Enumeration Date	:	07/08/2024
Last Update Date	:	07/08/2024

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Directions to “WHITING ORTHODONTICS PLLC ” Practice Location

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