Provider Demographics
NPI:1477673242
Name:WHITE ORTHODONTICS DDS PC
Entity Type:Organization
Organization Name:WHITE ORTHODONTICS DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:H
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:816-523-2343
Mailing Address - Street 1:207 EAST 63RD STREET
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64113-2224
Mailing Address - Country:US
Mailing Address - Phone:816-523-2343
Mailing Address - Fax:816-523-7210
Practice Address - Street 1:207 EAST 63RD STREET
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64113-2224
Practice Address - Country:US
Practice Address - Phone:816-523-2343
Practice Address - Fax:816-523-7210
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty