NPIMap

Organization Active NPI

White Pine Dental Group PLLC

  • General Practice Dentistry
  • Harlan, IA
National Provider Identifier
1043443260
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7374 Issued in IA
Legal business name
WHITE PINE DENTAL GROUP PLLC
Practice address
2105 Pine St
Harlan, IA 51537
Phone
(712) 755-5342
Fax
(712) 755-5666
NPI assigned
Sep 4, 2009
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Phillip L Markham, DDSNPI 1356457535
Title
Owner/Dentist
Phone
(712) 755-5342

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 7374 IA Primary

Addresses

Primary practice location

2105 Pine St
Harlan, IA 51537

Mailing address

2105 Pine St
Harlan, IA 51537
Phone (712) 755-5342

Other identifiers 3

IdentifierTypeStateIssuer
1487883948MedicaidIA
1639364383MedicaidIA
1356457535MedicaidIA

Other names 1

  • Markham Family Dental Associates Former legal business name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1252022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1043443260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2105 PINE ST",
            "city": "HARLAN",
            "state": "IA",
            "postal_code": "51537",
            "telephone_number": "712-755-5342",
            "fax_number": "712-755-5666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2105 PINE ST",
            "city": "HARLAN",
            "state": "IA",
            "postal_code": "51537",
            "telephone_number": "712-755-5342",
            "fax_number": "712-755-5666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHITE PINE DENTAL GROUP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-04",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "MARKHAM",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "712-755-5342",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "7374",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1487883948",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1639364383",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1356457535",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Markham Family Dental Associates",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Harlan, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.