Provider Demographics
NPI:1437230521
Name:WHITE, JAMIE ROBIN (DMD)
Entity Type:Individual
Prefix:DR
First Name:JAMIE
Middle Name:ROBIN
Last Name:WHITE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:JAMIE
Other - Middle Name:ROBIN
Other - Last Name:PHELPS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:205 N PHOENIX RD # 410
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:OR
Mailing Address - Zip Code:97535-9104
Mailing Address - Country:US
Mailing Address - Phone:541-535-4142
Mailing Address - Fax:541-535-3415
Practice Address - Street 1:205 N PHOENIX RD STE 410
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:OR
Practice Address - Zip Code:97535-9104
Practice Address - Country:US
Practice Address - Phone:541-535-4142
Practice Address - Fax:541-535-3415
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD81601223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR027915OtherOMAP