Provider Demographics
NPI:1255499869
Name:WHITE, SONYA F (DDS)
Entity Type:Individual
Prefix:
First Name:SONYA
Middle Name:F
Last Name:WHITE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:SONYA
Other - Middle Name:F
Other - Last Name:WHITE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:6309 PICCADILLY SQUARE DRIVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36695
Mailing Address - Country:US
Mailing Address - Phone:251-341-1500
Mailing Address - Fax:251-341-1400
Practice Address - Street 1:6309 PICCADILLY SQUARE DRIVE
Practice Address - Street 2:SUITE A
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36695
Practice Address - Country:US
Practice Address - Phone:251-341-1500
Practice Address - Fax:251-341-1400
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2010-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALLNO49661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS04727349Medicaid