Provider Demographics
NPI:1679317994
Name:WILLIAMSON, WHITNEY LEIGH (DDS)
Entity type:Individual
Prefix:MS
First Name:WHITNEY
Middle Name:LEIGH
Last Name:WILLIAMSON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:MRS
Other - First Name:WHITNEY
Other - Middle Name:
Other - Last Name:WISENER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:110 S 20TH STREET
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72758
Mailing Address - Country:US
Mailing Address - Phone:501-772-1837
Mailing Address - Fax:
Practice Address - Street 1:110 S 20TH STREET
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72758
Practice Address - Country:US
Practice Address - Phone:501-772-1837
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-21
Last Update Date:2024-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR47481223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice