White Pine Endodontics PC

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

8362186-9922 Issued in UT

Legal business name

WHITE PINE ENDODONTICS PC

Practice address

169 N Gateway Dr Ste 200
Providence, UT 84332-9516

Phone

(435) 760-4346

NPI assigned

Jul 25, 2017

Organization subpart

No

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

Authorized official

Name

Jordan Hansen, DDS

Title

President

Phone

(435) 760-4346

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1500940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1500940800000",
    "number": "1457874059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "169 N GATEWAY DR STE 200",
            "city": "PROVIDENCE",
            "state": "UT",
            "postal_code": "843329516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "169 N GATEWAY DR STE 200",
            "city": "PROVIDENCE",
            "state": "UT",
            "postal_code": "843329516",
            "telephone_number": "435-760-4346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHITE PINE ENDODONTICS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-25",
        "last_updated": "2017-07-25",
        "status": "A",
        "authorized_official_last_name": "HANSEN",
        "authorized_official_first_name": "JORDAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "435-760-4346",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": "UT",
            "license": "8362186-9922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jesse Charles Washburn, DO
• McKinzie Weber
• Steven John Weber, DO
• Erin A Welker, CRNA
• Amele Paige Welliver
• Sabrina White
• Kellie Whiton, PT, DPT
• Wholelife Family Wellness Clinic of Providence PLLC
• Mandy Wilcox
• Eric Cameron Wilkes, RBT

• Endodontics in Providence, UT
• Providers in Providence, UT by specialty
• Endodontics in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 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.