Provider Demographics
NPI:1942640495
Name:WHITE, JULIA MK (DDS)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:MK
Last Name:WHITE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8642 FOREST RD
Mailing Address - Street 2:
Mailing Address - City:GOODE
Mailing Address - State:VA
Mailing Address - Zip Code:24556
Mailing Address - Country:US
Mailing Address - Phone:540-587-5707
Mailing Address - Fax:540-587-5727
Practice Address - Street 1:8642 FOREST RD
Practice Address - Street 2:
Practice Address - City:GOODE
Practice Address - State:VA
Practice Address - Zip Code:24556
Practice Address - Country:US
Practice Address - Phone:540-587-5707
Practice Address - Fax:540-587-5727
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-28
Last Update Date:2019-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401414026122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist