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NPI 1114213048

NPI 1114213048 : EMILY JORDAN WHITTINGTON DDS : DALLAS, TX

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General NPI Number Information
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    NPI Number           |    1114213048
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    Entity Type          |    Individual 
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    Provider Name        |    EMILY JORDAN WHITTINGTON DDS
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    06/20/2011
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    Last Update Date     |    06/20/2011
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Provider Practice Location Address
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    Address Line         |    4470 W JEFFERSON BLVD SUITE 500
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    City                 |    DALLAS
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    State                |    TX
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    Zip                  |    75211-4615
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    Country              |    US
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    Telephone            |    214-333-3100
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1125 DERBYSHIRE PL 
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    City                 |    CARROLLTON
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    State                |    TX
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    Zip                  |    75007-4806
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    1223G0001X
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    Taxonomy Name        |    General Practice Dentistry
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    License Number       |    27040
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    License Number State |    TX
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