MEDICARE: DR. JAMES JOHN WHITE DDSLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	3346	NV

General Provider Information

NPI Number	:	1326173188
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES JOHN WHITE DDSLLC

Provider Business Mailing Address
First Line	:	9420 SUNDIAL DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89134-7823
Country	:	US
Telephone Number	:	702-562-3989
Fax Number	:

Provider Business Practice Location Address
First Line	:	1140 N TOWN CENTER DR STE 170
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89144-0601
Country	:	US
Telephone Number	:	702-562-8833
Fax Number	:	702-562-7910

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/22/2007
Last Update Date	:	03/03/2008

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Directions to “ DR. JAMES JOHN WHITE DDSLLC” Practice Location

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