Provider Demographics
NPI:1093848343
Name:WHITE, BEN GENE (DDS, MSD)
Entity Type:Individual
Prefix:DR
First Name:BEN
Middle Name:GENE
Last Name:WHITE
Suffix:
Gender:M
Credentials:DDS, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33507 9TH AVE S STE G
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-6397
Mailing Address - Country:US
Mailing Address - Phone:253-661-7228
Mailing Address - Fax:
Practice Address - Street 1:33507 9TH AVE S STE G
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-6397
Practice Address - Country:US
Practice Address - Phone:532-661-7228
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1011161223X0400X, 1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORD8261OtherLICENSE NUMBER