Healthcare Provider Details

I. General information

NPI: 1447049309
Provider Name (Legal Business Name): DANIELLE NICOLE WHITTAKER D.D.S
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2025
Last Update Date: 05/28/2025
Certification Date: 05/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8284 BEECHMONT AVE
CINCINNATI OH
45255-3153
US

IV. Provider business mailing address

3330 CANNON RD
TWINSBURG OH
44087-1816
US

V. Phone/Fax

Practice location:
  • Phone: 513-231-1012
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number30.028018
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: