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General NPI Number Information
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NPI Number | 1972639870
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Entity Type | Individual
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Provider Name | KEITH L WHITE DMD
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Gender | Male
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Dates
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Enumeration Date | 02/26/2007
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Last Update Date | 01/16/2015
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Provider Practice Location Address
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Address Line | 800 ROSE ST RM D104 UNIVERSITY OF KENTUCKY COLLEGE OF DENTISTRY
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City | LEXINGTON
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State | KY
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Zip | 40536-0297
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Country | US
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Telephone | 859-257-1494
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Fax | 859-257-5859
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Provider Business Mailing Address
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Address Line | 800 ROSE ST RM D104 UNIVERSITY OF KENTUCKY COLLEGE OF DENTISTRY
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City | LEXINGTON
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State | KY
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Zip | 40536-0297
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Country | US
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Telephone | 859-257-1494
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Fax | 859-257-5859
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 6009
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 1223D0001X
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Taxonomy Name | Public Health Dentistry
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License Number | 6009
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 6009
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License Number State | KY
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Taxonomy #4
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 6009
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License Number State | KY
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