MEDICARE: DR. MARK WHITING DMD

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	S3-329	NV

General Provider Information

NPI Number	:	1770036709
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARK WHITING DMD

Provider Business Mailing Address
First Line	:	6620 SKY POINTE DR STE 100
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89131-4001
Country	:	US
Telephone Number	:
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	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/26/2016
Last Update Date	:	05/28/2024

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Directions to “ DR. MARK WHITING DMD” Practice Location

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