Brilliant White Dental PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

BRILLIANT WHITE DENTAL PLLC

Practice address

2151 S Highway 92 Ste 109
Sierra Vista, AZ 85635-5283

Phone

(520) 730-8388

NPI assigned

Jan 17, 2023

Last updated

Jul 17, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Fredric J. White, DDSNPI 1215157953

Title

Owner

Phone

(520) 730-8388

Specialties & licenses 2

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Fredric J White, DDS

  • General Practice Dentistry
  • Sierra Vista, AZ
  • NPI 1215157953
  NPD Authorized official

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

{
    "created_epoch": "1673913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689552000000",
    "number": "1477268100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2151 S HIGHWAY 92 STE 109",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856355283",
            "telephone_number": "520-730-8388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2151 S HIGHWAY 92 STE 109",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856355283",
            "telephone_number": "520-730-8388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRILLIANT WHITE DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-17",
        "last_updated": "2023-07-17",
        "certification_date": "2023-07-17",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "FREDRIC",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "520-730-8388",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Jeanelle Bradshaw, REGISTERED DIETICIAN
• Dorlyne Michelle Brchan, M.D.
• Breaking Stasis LLC (Breaking Stasis Therapy, Crisis Management, And Consulting)
• Susan Breen, ED.S
• Andrea Lynn Bridges, RN
• Bring About Changes LLC
• Jamie Brott
• Alexia Faye Brown
• Eduardo N Brown, M.D.
• Victoria Marie Brown

• General Practice Dentistry in Sierra Vista, AZ
• Providers in Sierra Vista, AZ by specialty
• General Practice Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2023; 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.