Individual provider Active NPI

Jessica L White, DMD

  • General Practice Dentistry
  • Hull, MA
National Provider Identifier
1699783605
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
20769 Issued in MA
Practice address
529 Nantasket Ave
Hull, MA 02045
Phone
(781) 925-5100
Fax
(781) 925-9791
NPI assigned
Aug 4, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 20769 MA Primary

Addresses

Primary practice location

529 Nantasket Ave
Hull, MA 02045

Mailing address

PO Box 480
529 Nantasket Ave
Hull, MA 02045
Phone (781) 925-5100

Other identifiers 1

IdentifierTypeStateIssuer
0297291MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150527001775 MA Order and Referring Only - DentistPractitioner - Dentist 5597085803

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
20769MAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Locke White Dental Associates LLC General Practice Past Accepting new patients
Hull Family Dental, LLC General Practice PastSince Sep 29, 2019 Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699783605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 480",
            "address_2": "529 NANTASKET AVE",
            "city": "HULL",
            "state": "MA",
            "postal_code": "02045",
            "telephone_number": "781-925-5100",
            "fax_number": "781-925-9791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "529 NANTASKET AVE",
            "city": "HULL",
            "state": "MA",
            "postal_code": "02045",
            "telephone_number": "781-925-5100",
            "fax_number": "781-925-9791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "JESSICA",
        "middle_name": "L",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "20769",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0297291",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hull, MA

Sources for this page

Verify at the official NPI Registry.