Sander Irwin White, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

017466 Issued in PA

Practice address

2193 W Chester Pike
Broomall, PA 19008-3029

Phone

(610) 353-6161

Fax

(610) 353-0562

NPI assigned

May 19, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Oct 1, 2019 through Oct 1, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Advanced Dental Concepts of Broomall PC

  • General Practice Dentistry
  • Broomall, PA
  • NPI 1063394880
  NPD (past)

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1861445678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2193 W CHESTER PIKE",
            "city": "BROOMALL",
            "state": "PA",
            "postal_code": "190083029",
            "telephone_number": "610-353-6161",
            "fax_number": "610-353-0562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2193 W CHESTER PIKE",
            "city": "BROOMALL",
            "state": "PA",
            "postal_code": "190083029",
            "telephone_number": "610-353-6161",
            "fax_number": "610-353-0562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "SANDER",
        "middle_name": "IRWIN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "017466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hanna Chaya Weintraub, OTR/L, CLT
• Karen Weiss, LSW
• Melissa Vanderwolf Weldon, LCSW-C
• Bridgett Wendel, PHARMD
• West Chester Optometry, P.C.
• Sharon Denise White, MSS, LCSW
• Jamie Lynn Whitesell
• Gerolyn Wilcox
• Caroline Wilkinson, NURSE PRACTITIONER
• Matthew Willard

• General Practice Dentistry in Broomall, PA
• Providers in Broomall, PA by specialty
• General Practice Dentistry in Pennsylvania

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.