Provider Demographics
NPI:1396853131
Name:HERMIONE A WHITE DDS PC
Entity Type:Organization
Organization Name:HERMIONE A WHITE DDS PC
Other - Org Name:GENTLE DENTIST
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:HERMIONE
Authorized Official - Middle Name:A
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:281-376-0122
Mailing Address - Street 1:13615 PRISTINE LAKE LN
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429-6010
Mailing Address - Country:US
Mailing Address - Phone:281-376-0122
Mailing Address - Fax:281-376-2472
Practice Address - Street 1:13050 LOUETTA RD
Practice Address - Street 2:#216
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-5215
Practice Address - Country:US
Practice Address - Phone:281-376-0122
Practice Address - Fax:281-376-2472
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15219122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty