Clarice Rena White, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS0000005088 Issued in TN

Practice address

12173 Main St Ste B
Mason, TN 38049-7054

Phone

(901) 294-2634

Fax

(901) 294-2639

NPI assigned

Nov 8, 2005

Last updated

Jun 14, 2017By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in TN

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

Medicare enrollment (NPD)

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.

• Dr. C.R. White and Associates Dental Center,Inc.

  dba Dr. Clarice R. White

  • General Practice Dentistry
  • Mason, TN
  • NPI 1235448598
  NPD (past) Authorized official
• Mason Health Clinic

  • Rural Health Clinic/Center
  • Mason, TN
  • NPI 1366112732
  NPD (past)

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

{
    "created_epoch": "1131408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1497398400000",
    "number": "1891776845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12173 MAIN ST",
            "address_2": "SUITE B",
            "city": "MASON",
            "state": "TN",
            "postal_code": "380497054",
            "telephone_number": "901-294-2634",
            "fax_number": "901-294-2639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12173 MAIN ST STE B",
            "city": "MASON",
            "state": "TN",
            "postal_code": "380497054",
            "telephone_number": "901-294-2634",
            "fax_number": "901-294-2639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "CLARICE",
        "middle_name": "RENA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-11-08",
        "last_updated": "2017-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "DS0000005088",
            "primary": true
        },
        {
            "code": "246RM2200X",
            "taxonomy_group": "",
            "desc": "Technician, Pathology, Medical Laboratory",
            "state": "TN",
            "license": "ML0000008122",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD",
            "identifier": "4098095",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3225798",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "DS005088",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3205221",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DORAL DENTAL",
            "identifier": "4777",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stella Mireles
• Christopher T. Short
• Sugarspoon, LLC (SugarSpoon Hometown Pharmacy)
• Tiffany Lashelle Taylor, SFNP
• Terrycare Senior Community Services (TerryCare)

• General Practice Dentistry in Mason, TN
• Providers in Mason, TN by specialty
• General Practice Dentistry in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2017; 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.