RANDALL LACEY WHITTEN (NPI# 1356358212) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356358212 |
| Entity Type | Individual |
| Full Name | RANDALL LACEY WHITTEN |
| Credential | D.D.S. |
| Practice Address |
8700 Crownhill Blvd Ste 210 San Antonio TX 78209-1126 |
| Practice Telephone | 2108249488 |
| Practice Fax Number | 2108249564 |
| Mailing Telephone | 2108249488 |
| Mailing Fax Number | 2108249564 |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
11391 | TX | Dental Providers |
| Street Address |
8700 CROWNHILL BLVD STE 210 |
| City | SAN ANTONIO |
| State | TX |
| Zip Code | 78209-1126 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891346359 | Westlake Dermatology of San Antonio Pllc | Dermatology | 5500 Broadway Ave Ste R100, Alamo Heights, TX 78209 | 2019-09-26 |
| 1265086045 | Westlake Dermatology, Pa | Dermatology | 5500 Broadway Ave, Alamo Heights, TX 78209 | 2019-07-30 |
| 1194207530 | Arthur Davies | Licensed Vocational Nurse | 8700 Crownhill Blvd #300, San Antonio, TX 78209 | 2018-09-01 |
| 1538649462 | Jessica Michelle Moore | Licensed Vocational Nurse | 8400 Crown Hill Blvd, San Antonio, TX 78209 | 2018-08-20 |
| 1871072645 | Olawunmi Olapeju Odele | Licensed Vocational Nurse | 8700 Crownhill Blvd. Ste.300, San Antonio, TX 78209 | 2018-08-12 |
| 1265921126 | Ashley L Garcia | Physician Assistant | 414 W Sunset Rd Ste 205, San Antonio, TX 78209 | 2018-05-07 |
| 1083117428 | New Choices Treatment Center LLC | Substance Abuse Rehabilitation Facility | 3050 Eisenhauer Rd Apt 501, San Antonio, TX 78209 | 2018-03-12 |
| 1629570106 | Julieta Rubio Hobbs | Counselor | 4301 Broadway St. 438, San Antonio, TX 78209 | 2018-03-01 |
| 1326550187 | Shannon Lee Crowley | Occupational Therapy Assistant | 403 Irvington Dr, San Antonio, TX 78209 | 2017-11-01 |
| 1932627007 | Juanita De Luna Salazar | Physical Therapist | 1635 Ne Interstate 410 Loop, #600, San Antonio, TX 78209 | 2017-09-08 |
| Find all providers in zip 78209 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295344679 | Bulverde Dental Specialist Pllc | Dentist | 22103 Bulverde Rd Ste 108, San Antonio, TX 78259-1855 | 2020-07-30 |
| 1407478027 | Rittiman Pediatric Dentistry, Pllc | Dentist | 5723 N Foster Rd, San Antonio, TX 78244-1204 | 2020-05-18 |
| 1669011235 | Kusom Pediatric Dental South Pllc | Dentist | 1134 Culebra Rd Ste 109, San Antonio, TX 78201-6080 | 2019-12-31 |
| 1114563590 | Zaida Liliana Nieves Lopez | Dentist | 226 Serna Park, San Antonio, TX 78218-2035 | 2019-11-21 |
| 1356997126 | Northeast Children's Dentistry, Inc | Dentist | 315 N San Saba Ste 202, San Antonio, TX 78207-3193 | 2019-08-16 |
| 1033765094 | Northeast Children's Dentistry, Inc | Dentist | 21727 Ih 10 W Ste 203, San Antonio, TX 78257-2107 | 2019-08-15 |
| 1598310344 | Celebraces Se Military Pllc | Dentist | 3611 Se Military Drive, Suite B101, San Antonio, TX 78223 | 2019-08-08 |
| 1972068401 | Aventura Dental | Dentist | 11915 Perrin Beitel Rd, San Antonio, TX 78217-2127 | 2019-02-08 |
| 1427513316 | San Antonio Pediatric Dentistry, Pllc | Dentist | 17026 Bulverde Rd Ste 102, San Antonio, TX 78247-4700 | 2019-02-05 |
| 1104394816 | Cassandra Elkins Dds, Pllc | Dentist | 9543 Huebner Rd, San Antonio, TX 78240-1510 | 2018-11-12 |
| Find all providers in SAN ANTONIO | ||||
| City | SAN ANTONIO |
| Zip Code | 78209 |
Please comment or provide details below to improve the information on RANDALL LACEY WHITTEN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.