Healthcare Provider Details

I. General information

NPI: 1780405613
Provider Name (Legal Business Name): WHITNEY SCOTT RDHAP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/23/2024
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13157 MINDANAO WAY # 568
MARINA DEL REY CA
90292-6307
US

IV. Provider business mailing address

5425 W SLAUSON AVE
LOS ANGELES CA
90056-1046
US

V. Phone/Fax

Practice location:
  • Phone: 310-728-9658
  • Fax:
Mailing address:
  • Phone: 310-728-9658
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License NumberHAP1099
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: