Physician Compare National (NPI:1487616124)

HEALTHCARE PROVIDER: DENNIS LEE WHITE OD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1487616124
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	5991813818
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20120327000668
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	WHITE
	Individual professional last name
Provider First Name	DENNIS
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF MISSOURI ST LOUIS - SCHOOL OF OPTOMETRY
	Individual professional's medical school
Graduation Year	1989
	Individual professional's medical school graduation year
Primary Specialty	OPTOMETRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	1100 W SCENIC RIVERS BLVD A
	Group Practice or individual's line 1 address
Line 2 Street Address	FAMILY EYE CARE
	Group Practice or individual's line 2 address
City	SALEM
	Group Practice or individual's city
State	MO
	Group Practice or individual's state
Zip Code	655602811
	Group Practice or individual's zip code (9 digits when available)
Phone Number	5737294300
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y