Active NPI
Robert Russell White, DMD
- Dentist
- Boston, MA
National Provider Identifier
1700976115
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 12762
- Practice address
- 188 Longwood Ave
Harvard School of Dental Medicine
Boston, MA 02115 - Phone
- (617) 432-1445
- Fax
- (617) 432-0901
- NPI assigned
- Oct 14, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 12762 | MA | Primary |
Addresses
Primary practice location
188 Longwood Ave
Harvard School of Dental Medicine
Boston, MA 02115
Mailing address
188 Longwood Ave
Harvard School of Dental Medicine
Boston, MA 02115
Phone (617) 432-1445
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12762 | MA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160784000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1700976115",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "188 LONGWOOD AVE",
"address_2": "HARVARD SCHOOL OF DENTAL MEDICINE",
"city": "BOSTON",
"state": "MA",
"postal_code": "02115",
"telephone_number": "617-432-1445",
"fax_number": "617-432-0901"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "188 LONGWOOD AVE",
"address_2": "HARVARD SCHOOL OF DENTAL MEDICINE",
"city": "BOSTON",
"state": "MA",
"postal_code": "02115",
"telephone_number": "617-432-1445",
"fax_number": "617-432-0901"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITE",
"first_name": "ROBERT",
"middle_name": "RUSSELL",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MA",
"license": "12762",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.