Provider Demographics
NPI:1023230489
Name:WHITE, RON S (DDS)
Entity type:Individual
Prefix:DR
First Name:RON
Middle Name:S
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 1:4189 EAST HWY 290
Mailing Address - Street 2:
Mailing Address - City:DRIPPING SPRINGS
Mailing Address - State:TX
Mailing Address - Zip Code:78620
Mailing Address - Country:US
Mailing Address - Phone:512-501-3839
Mailing Address - Fax:888-854-6676
Practice Address - Street 1:14101 WEST HWY 290 SUITE 200
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78737
Practice Address - Country:US
Practice Address - Phone:512-894-4777
Practice Address - Fax:512-894-3426
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2010-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18730122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX18730OtherTEXAS STATE LICENSE NUMBE
TX470955437OtherTAX IDENTIFICATION NUMBER