WHITE MOUNTAIN DENTISTRY NPI 1942524335

Point of Service in Snowflake, AZ

NPI 1942524335 Organization Point of Service

About WHITE MOUNTAIN DENTISTRY

White Mountain Dentistry is a provider established in Snowflake, Arizona specializing in point of service. The NPI number of White Mountain Dentistry is 1942524335 and was assigned on March 2010. The practitioner's primary taxonomy code is 305S00000X with license number AZ7350 (AZ). The provider is registered as an organization and their NPI record was last updated 12 years ago. The authorized official of this NPI record is Mr. Benjamin L Tenney (Owner)

NPI

1942524335

Provider NameWHITE MOUNTAIN DENTISTRY
Provider Location Address986 S MAIN ST SNOWFLAKE, AZ 85937
Provider Mailing Address986 S MAIN ST SNOWFLAKE, AZ 85937
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Enumeration Date03-15-2010
Last Update Date03-15-2010


Primary Taxonomy

Taxonomy Code305S00000X
ClassificationPoint of Service
TypeManaged Care Organizations
License No.AZ7350
License StateAZ
Taxonomy DescriptionThis product may also be called an open-ended HMO and offers a transition product incorporating features of both HMOs and PPOs. Beneficiaries are enrolled in an HMO but have the option to go outside the networks for an additional cost.

Business Address

WHITE MOUNTAIN DENTISTRY
986 S MAIN ST
SNOWFLAKE, AZ
ZIP 85937
Phone: (928) 536-5353
Fax: (928) 536-5753

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Mailing Address

WHITE MOUNTAIN DENTISTRY
986 S MAIN ST
SNOWFLAKE, AZ
ZIP 85937
Phone: (928) 536-5353
Fax: (928) 536-5753



Authorized Official

Authorized Official NameMR. BENJAMIN L TENNEY
Authorized Official TitleOWNER
Authorized Official Phone(928) 536-5353

Other Providers at the same location


The following 4 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1639197809 JAMES RANDALL OLSON DDS
Individual
Dentist986 S MAIN ST
SNOWFLAKE, AZ 85937
(928) 536-5353
1083715247DR. KENNETH FLOYD RICE D.M.D.
Individual
Dentist (General Practice)986 S MAIN ST
SNOWFLAKE, AZ 85937
(928) 536-7159
1417148008DR. TRAVIS LYNN CASKEY D.M.D.
Individual
Dentist986 S MAIN ST
SNOWFLAKE, AZ 85937
(928) 536-7159
1730343013 KENNETH HOUSTON DAVIS DMD
Individual
Dentist986 S MAIN ST
SNOWFLAKE, AZ 85937
(928) 536-5773

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.