Healthcare Provider Details

I. General information

NPI: 1982743878
Provider Name (Legal Business Name): SARA H WILHITE DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/06/2007
Last Update Date: 05/26/2021
Certification Date: 05/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1218 NE WINDSOR DR
LEES SUMMIT MO
64086-5594
US

IV. Provider business mailing address

1218 NE WINDSOR DR
LEES SUMMIT MO
64086-5594
US

V. Phone/Fax

Practice location:
  • Phone: 816-554-7668
  • Fax: 816-554-7651
Mailing address:
  • Phone: 816-554-7668
  • Fax: 816-554-7651

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number2020017921
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: