Active NPI
Robert Lee White Jr., D.D.S.
- General Practice Dentistry
- Fairburn, GA
National Provider Identifier
1942279310
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DN012581
- Practice address
- 168 NW Broad St
Fairburn, GA 30213-1436 - Phone
- (770) 964-1545
- Fax
- (770) 964-1031
- NPI assigned
- Mar 16, 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DN012581 | GA | Primary |
Addresses
Primary practice location
168 NW Broad St
Fairburn, GA 30213-1436
Mailing address
168 NW Broad St
Fairburn, GA 30213-1436
Phone (770) 964-1545
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 630425143A | Medicaid | GA |
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 |
|---|---|---|---|
| DN012581 | GA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| R L White Jr., DDS & Associates, PC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Dentist
- Fairburn, GA
- NPI 1801046297
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142467200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1942279310",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "168 NW BROAD ST",
"city": "FAIRBURN",
"state": "GA",
"postal_code": "302131436",
"telephone_number": "770-964-1545",
"fax_number": "770-964-1031"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "168 NW BROAD ST",
"city": "FAIRBURN",
"state": "GA",
"postal_code": "302131436",
"telephone_number": "770-964-1545",
"fax_number": "770-964-1031"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITE",
"first_name": "ROBERT",
"middle_name": "LEE",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-16",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "GA",
"license": "DN012581",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "630425143A",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fairburn, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.