Whitehaven Dental Care Inc.

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

WHITEHAVEN DENTAL CARE INC.

Practice address

1273 E Raines Rd
Memphis, TN 38116-5816

Phone

(901) 398-6435

Fax

(901) 398-1987

NPI assigned

Mar 20, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Ragonva Shante Walls, DDSNPI 1013062249

Title

Dentist

Phone

(901) 398-6435

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ragonva Shante Walls, D.D.S

  • General Practice Dentistry
  • Memphis, TN
  • NPI 1013062249
  NPD (past) Authorized official
• Charles Stephen Zitek, DDS

  • General Practice Dentistry
  • Memphis, TN
  • NPI 1639230212
  NPD (past)

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

{
    "created_epoch": "1489968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489968000000",
    "number": "1104367481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1273 E RAINES ROAD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "38116",
            "telephone_number": "901-398-6435",
            "fax_number": "901-398-1987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1273 E RAINES RD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381165816",
            "telephone_number": "901-398-6435",
            "fax_number": "901-398-1987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHITEHAVEN DENTAL CARE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-20",
        "last_updated": "2017-03-20",
        "status": "A",
        "authorized_official_last_name": "WALLS",
        "authorized_official_first_name": "RAGONVA",
        "authorized_official_middle_name": "SHANTE",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "901-398-6435",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "TN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Timothy White, RN
• Trameciea Sharneice White, NURSE PRACTITIONER
• William E White, OD
• Yolonda Marie White, DPH
• Erica Whiteaker
• Whitehaven Pediatrics Inc.
• Clayton Thomas Whitfield, AU.D.
• Whiting Young LLC
• Tanner Whiting, MD
• Meris M Whitley, APRN

• All providers in Memphis, TN
• Dentist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2017; 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.