Healthcare Provider Details

I. General information

NPI: 1871455352
Provider Name (Legal Business Name): DENTRICE WHITT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/02/2025
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11321 METHYL AVE
CLEVELAND OH
44120-2103
US

IV. Provider business mailing address

11321 METHYL AVE
CLEVELAND OH
44120-2103
US

V. Phone/Fax

Practice location:
  • Phone: 216-635-8987
  • Fax:
Mailing address:
  • Phone: 216-635-8987
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: