Provider Demographics
NPI:1922004951
Name:WHITE, RAYMOND P (DDS/PHD)
Entity Type:Individual
Prefix:
First Name:RAYMOND
Middle Name:P
Last Name:WHITE
Suffix:
Gender:M
Credentials:DDS/PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1506 VELMA ROAD
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514
Mailing Address - Country:US
Mailing Address - Phone:919-401-6462
Mailing Address - Fax:919-966-6019
Practice Address - Street 1:UNC ORAL AND MAXILLOFACIAL SURGERY
Practice Address - Street 2:115 BRAUER HALL, CB #7450
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27599-7450
Practice Address - Country:US
Practice Address - Phone:919-966-1126
Practice Address - Fax:919-966-6019
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC40261223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC241101Medicare ID - Type Unspecified
NCT97075Medicare UPIN