Healthcare Provider Details

I. General information

NPI: 1134295553
Provider Name (Legal Business Name): DON MICHAEL WHITTEN D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7400 N HILLS BLVD
SHERWOOD AR
72116-4539
US

IV. Provider business mailing address

7400 N HILLS BLVD
SHERWOOD AR
72116-4539
US

V. Phone/Fax

Practice location:
  • Phone: 501-835-4567
  • Fax: 501-834-9178
Mailing address:
  • Phone: 501-835-4567
  • Fax: 501-834-9178

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number2097
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: