Provider Demographics
NPI:1093258162
Name:JAMES L. WHITE DDS PA
Entity Type:Organization
Organization Name:JAMES L. WHITE DDS PA
Other - Org Name:WHITE DENTAL
Other - Org Type:Other Name
Authorized Official - Title/Position:DOCTOR/ OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:LANKFORD
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, PA
Authorized Official - Phone:910-329-8191
Mailing Address - Street 1:PO BOX 279
Mailing Address - Street 2:
Mailing Address - City:HOLLY RIDGE
Mailing Address - State:NC
Mailing Address - Zip Code:28445-0279
Mailing Address - Country:US
Mailing Address - Phone:910-329-8191
Mailing Address - Fax:910-329-0202
Practice Address - Street 1:200 US HIGHWAY 17 N
Practice Address - Street 2:
Practice Address - City:HOLLY RIDGE
Practice Address - State:NC
Practice Address - Zip Code:28445-7826
Practice Address - Country:US
Practice Address - Phone:910-329-8191
Practice Address - Fax:910-329-0202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-22
Last Update Date:2016-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6641122300000X
332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized EquipmentGroup - Single Specialty