Shaun Travis White, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

10160 Issued in NC

Practice address

1310 Wayne Memorial Dr Ste C
Goldsboro, NC 27534-2269

Phone

(919) 581-0909

Fax

(833) 780-5944

NPI assigned

Aug 6, 2009

Sex

Male

Sole proprietor

Yes

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

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: shaun.white.p1@direct.personfamily.nextgenshare.com

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.

• Kyle Roth and Associates VI, DDS, PA

  • General Practice Dentistry
  • Goldsboro, NC
  • NPI 1740371616
  NPD (past)

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

{
    "created_epoch": "1249516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576627200000",
    "number": "1669603718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 WAYNE MEMORIAL DR STE C",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275342269",
            "telephone_number": "919-581-0909",
            "fax_number": "833-780-5944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 WAYNE MEMORIAL DR STE C",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275342269",
            "telephone_number": "919-581-0909",
            "fax_number": "833-780-5944"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2005 Knight Lane Bldg. H",
            "address_2": "Navy Medicine Support Command, Attn: MSSD",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322120140",
            "country_code": "US",
            "telephone_number": "617-407-7977",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHITE",
        "first_name": "SHAUN",
        "middle_name": "TRAVIS",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-08-06",
        "last_updated": "2019-12-18",
        "certification_date": "2019-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "10160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brent Ashley Westbrook, P.A.-C
• Christy Rose Westbrook
• Western Wayne Medical Center
• What Is Autism
• Robert Gerald White Jr., CRNA
• Tiana Kashira Whitehead, OT
• Howard Gregory Whitfield
• Kristie W Whitfield, PHLEBOTOMIST
• Renita Whitfield, RN
• Ashlyn Whitley

• General Practice Dentistry in Goldsboro, NC
• Providers in Goldsboro, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2019; 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.

Verify at the official NPI Registry.