Tyresia Jovon White, DMD

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

904 Issued in SC

Practice address

440 Society Hill Dr Ste 201
Aiken, SC 29803

Phone

(803) 716-8054

Fax

(803) 642-1395

NPI assigned

Jul 25, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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.

• Classic Dental Group

  • Dentist
  • Greenville, SC
  • NPI 1902458474
  NPD (past) Authorized official

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

{
    "created_epoch": "1374710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575331200000",
    "number": "1346682754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 SOCIETY HILL DR STE 201",
            "city": "AIKEN",
            "state": "SC",
            "postal_code": "298031755",
            "telephone_number": "803-716-8054",
            "fax_number": "803-642-1395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 SOCIETY HILL DR STE 201",
            "city": "AIKEN",
            "state": "SC",
            "postal_code": "29803",
            "telephone_number": "803-716-8054",
            "fax_number": "803-642-1395"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Uk College Of Dentistry",
            "address_2": "800 Rose St RM D-432",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405360001",
            "country_code": "US",
            "telephone_number": "859-323-5391",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6A Cleveland Ct",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "SC",
            "postal_code": "296072414",
            "country_code": "US",
            "telephone_number": "864-283-0141",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Uk College Of Dentistry",
            "address_2": "800 Rose St RM D-432",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405360001",
            "country_code": "US",
            "telephone_number": "859-323-5391",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHITE",
        "first_name": "TYRESIA",
        "middle_name": "JOVON",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-25",
        "last_updated": "2019-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "SC",
            "license": "904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Morgan Whetstone
• Michelle Anne Whitaker, DNP, FNP-BC
• White Periodontics & Implant Dentistry
• McKenzie Clare White
• Thomas White
• Charlotte Collins Wiedenman, D.M.D.
• Brandon Wilcher
• Leah B Wilkins
• Carol Williams
• Cassandra Rochelle Rose Williams

• Periodontics in Aiken, SC
• Providers in Aiken, SC by specialty
• Periodontics in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2019; 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.