Healthcare Provider Details

I. General information

NPI: 1801458278
Provider Name (Legal Business Name): WILLIAM NEIL WHITE DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2019
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 ORCHARD DR
NICHOLASVILLE KY
40356-2690
US

IV. Provider business mailing address

215 E 11TH ST
NEWPORT KY
41071-2203
US

V. Phone/Fax

Practice location:
  • Phone: 859-881-4288
  • Fax: 859-881-4388
Mailing address:
  • Phone: 859-655-6100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number10525
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: