Provider Demographics
NPI:1538877725
Name:WHITAKER, JULIA DEAN (DMD, MS)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:DEAN
Last Name:WHITAKER
Suffix:
Gender:F
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1224 MCFARLAND BLVD NE
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35406-2287
Mailing Address - Country:US
Mailing Address - Phone:205-750-0081
Mailing Address - Fax:
Practice Address - Street 1:1224 MCFARLAND BLVD NE
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35406-2287
Practice Address - Country:US
Practice Address - Phone:205-750-0081
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-07
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALD68401223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics