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General NPI Number Information
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NPI Number | 1407581788
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Entity Type | Individual
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Provider Name | TYLER CARRINGTON WHITFIELD DDS
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Gender | Male
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Dates
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Enumeration Date | 07/20/2022
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Last Update Date | 11/17/2025
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Provider Practice Location Address
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Address Line | 8100 FOREST HILLS RD
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City | LOVES PARK
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State | IL
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Zip | 61111-2709
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Country | US
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Telephone | 815-403-0267
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Fax | 779-970-5745
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Provider Business Mailing Address
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Address Line | 8100 FOREST HILLS RD
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City | LOVES PARK
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State | IL
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Zip | 61111-2709
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Country | US
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Telephone | 779-210-3724
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Fax | 779-970-5745
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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 | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 12013805A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 019.033673
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 019.033673
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License Number State | IL
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