Provider Demographics
NPI:1417093774
Name:WHITE, JAMES THORPE (DDS)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:THORPE
Last Name:WHITE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2235 CHANNING WAY
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94704-2120
Mailing Address - Country:US
Mailing Address - Phone:510-841-2922
Mailing Address - Fax:510-841-1286
Practice Address - Street 1:2235 CHANNING WAY
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94704-2120
Practice Address - Country:US
Practice Address - Phone:510-841-2922
Practice Address - Fax:510-841-1286
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA277091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice