Javonne McKoy White, D.D.S.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

DN012650 Issued in GA

Practice address

168 NW Broad St
Fairburn, GA 30213-1436

Phone

(770) 964-1545

Fax

(770) 964-1031

NPI assigned

Mar 16, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• R L White Jr., DDS & Associates, PC

  • Dentist
  • Fairburn, GA
  • NPI 1801046297
  NPD (past)

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

{
    "created_epoch": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397606400000",
    "number": "1316916919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "168 NW BROAD ST",
            "city": "FAIRBURN",
            "state": "GA",
            "postal_code": "302131436",
            "telephone_number": "770-964-1545",
            "fax_number": "770-964-1031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "168 NW BROAD ST",
            "city": "FAIRBURN",
            "state": "GA",
            "postal_code": "302131436",
            "telephone_number": "770-964-1545",
            "fax_number": "770-964-1031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "JAVONNE",
        "middle_name": "MCKOY",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-16",
        "last_updated": "2014-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "GA",
            "license": "DN012650",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "452419657A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Leigh Wasson, PA-C
• Wellstreet of Georgia PC (Piedmont Urgent Care by Wellstreet)
• Derek A West
• Sandra West, REGISTERED NURSE
• Stephanie Westbrook, LPC
• Kennedy White
• Robert Lee White Jr., D.D.S.
• Jacarri Michelle Wilcots, LMSW
• Terence Wilkins
• Camesha Harp Williams, LCSW

• Orthodontics and Dentofacial Orthopedics Dentistry in Fairburn, GA
• Providers in Fairburn, GA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2014; 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.