MEDICARE: DR. SCOTT STEVEN WHITNEY DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	19773	OH

General Provider Information

NPI Number	:	1073661567
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SCOTT STEVEN WHITNEY DMD

Provider Business Mailing Address
First Line	:	7000 TOWN CENTRE DR
Second Line	:	SUITE 100
City	:	BROADVIEW HTS
State	:	OH
Zip	:	44147-4008
Country	:	US
Telephone Number	:	440-838-5550
Fax Number	:	440-838-5097

Provider Business Practice Location Address
First Line	:	7000 TOWN CENTRE DR
Second Line	:	SUITE 100
City	:	BROADVIEW HTS
State	:	OH
Zip	:	44147-4008
Country	:	US
Telephone Number	:	440-838-5550
Fax Number	:	440-838-5097

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/08/2007
Last Update Date	:	07/08/2007

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