Provider Demographics
NPI:1215046115
Name:WHITE, LINDA JEAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:JEAN
Last Name:WHITE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:LINDA
Other - Middle Name:J
Other - Last Name:WHITE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:7518 A DIPLOMAT DRIVE
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20109-2690
Mailing Address - Country:US
Mailing Address - Phone:703-257-1900
Mailing Address - Fax:703-257-5018
Practice Address - Street 1:7518 A DIPLOMAT DRIVE
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20109-2690
Practice Address - Country:US
Practice Address - Phone:703-257-1900
Practice Address - Fax:703-257-5018
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010062911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice