Healthcare Provider Details

I. General information

NPI: 1528989829
Provider Name (Legal Business Name): WHITLEY HALL DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

38209 47TH ST E STE E
PALMDALE CA
93552-3113
US

IV. Provider business mailing address

2320 GRANVILLE LN
LANCASTER CA
93535-3014
US

V. Phone/Fax

Practice location:
  • Phone: 661-236-0046
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number113616
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: