Active NPI
Charles Robert White II, DDS
- General Practice Dentistry
- Lafayette, LA
National Provider Identifier
1275652646
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- LA4994
- Practice address
- 320 Guilbeau Road
Lafayette, LA 70506 - Phone
- (337) 988-7783
- Fax
- (337) 988-7765
- NPI assigned
- Mar 28, 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 | LA4994 | LA | Primary |
Addresses
Primary practice location
320 Guilbeau Road
Lafayette, LA 70506
Mailing address
320 Guilbeau Road
Lafayette, LA 70506
Phone (337) 988-7783
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in LA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170120001278 | LA | Order and Referring Only - Other (Physician) | 4284916537 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LA4994 | LA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175040000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1234224000000",
"number": "1275652646",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "320 GUILBEAU ROAD",
"city": "LAFAYETTE",
"state": "LA",
"postal_code": "70506",
"telephone_number": "337-988-7783",
"fax_number": "337-988-7765"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "320 GUILBEAU ROAD",
"city": "LAFAYETTE",
"state": "LA",
"postal_code": "70506",
"telephone_number": "337-988-7783",
"fax_number": "337-988-7765"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITE",
"first_name": "CHARLES",
"middle_name": "ROBERT",
"name_prefix": "Dr.",
"name_suffix": "II",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-28",
"last_updated": "2009-02-10",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "LA",
"license": "LA4994",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lafayette, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2009; 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.