Individual provider Active NPI

Bernt E White, D.M.D

  • General Practice Dentistry
  • Ontario, OR
National Provider Identifier
1790783595
Registry record updated Jan 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
8131 Issued in OR
Practice address
347 W Idaho Ave
Ontario, OR 97914-2344
Phone
(541) 889-8837
Fax
(541) 889-8991
NPI assigned
Jul 14, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2010

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 8131 OR Primary

Addresses

Primary practice location

347 W Idaho Ave
Ontario, OR 97914-2344

Mailing address

347 W Idaho Ave
Ontario, OR 97914-2344
Phone (541) 889-8837

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20160226002100 OR Order and Referring Only - DentistPractitioner - Dentist 1951606029

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8131ORMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Clarke L Short DDS LLC Past Accepting new patients
White House Dental General Practice Past 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1121299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262563200000",
    "number": "1790783595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "347 W IDAHO AVE",
            "city": "ONTARIO",
            "state": "OR",
            "postal_code": "979142344",
            "telephone_number": "541-889-8837",
            "fax_number": "541-889-8991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "347 W IDAHO AVE",
            "city": "ONTARIO",
            "state": "OR",
            "postal_code": "979142344",
            "telephone_number": "541-889-8837",
            "fax_number": "541-889-8991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "BERNT",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-14",
        "last_updated": "2010-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "8131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ontario, OR

Sources for this page

Verify at the official NPI Registry.