Active NPI
Robert Wilson White, D.D.S.
- General Practice Dentistry
- Lake Geneva, WI
National Provider Identifier
1144234030
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 581G
- Practice address
- 415 Broad St
Suite 201
Lake Geneva, WI 53147-1800 - Phone
- (126) 224-8382
- NPI assigned
- Jul 28, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 581G | WI | Primary |
Addresses
Primary practice location
415 Broad St
Suite 201
Lake Geneva, WI 53147-1800
Mailing address
415 Broad St
Suite 201
Lake Geneva, WI 53147-1800
Phone (126) 224-8382
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 581G | WI | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154044800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1144234030",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "415 BROAD ST",
"address_2": "SUITE 201",
"city": "LAKE GENEVA",
"state": "WI",
"postal_code": "531471800",
"telephone_number": "126-224-8382"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "415 BROAD ST",
"address_2": "SUITE 201",
"city": "LAKE GENEVA",
"state": "WI",
"postal_code": "531471800",
"telephone_number": "126-224-8382"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITE",
"first_name": "ROBERT",
"middle_name": "WILSON",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-28",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "WI",
"license": "581G",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Geneva, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.