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General NPI Number Information
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NPI Number | 1477916724
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Entity Type | Individual
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Provider Name | SHAYNA NICOLE WHITEMAN DDS
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Gender | Female
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Dates
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Enumeration Date | 04/04/2016
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Last Update Date | 05/27/2020
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Provider Practice Location Address
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Address Line | 141 US HIGHWAY 46 LOWR LEVEL
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City | ROCKAWAY
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State | NJ
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Zip | 07866-4018
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Country | US
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Telephone | 973-625-3384
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Fax |
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Provider Business Mailing Address
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Address Line | 285 AYCRIGG AVE APT 5K
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City | PASSAIC
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State | NJ
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Zip | 07055-3722
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Country | US
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Telephone | 718-764-7290
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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 | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 22DI02663502
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License Number State | NJ
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