Individual provider Active NPI

Reginald R. Westphal, D.D.S., M.S.

  • Endodontics
  • Wellington, CO
National Provider Identifier
1023221165
Registry record updated Jun 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
100988 Issued in CO
Practice address
8017 First Street #C
Wellington, CO 80549-1595
Phone
(970) 775-4504
Fax
(970) 293-8303
NPI assigned
May 7, 2007
Last updated
Jun 11, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 100988 CO Primary

Addresses

Primary practice location

8017 First Street #C
Wellington, CO 80549-1595

Mailing address

3268 Wild West LN
Wellington, CO 80549-1595
Phone (719) 369-8122

Other practice location 1

3529 E Grand Ave # 82070
Laramie, WY 82070-5135
Phone (307) 460-9099

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
100988COMDEndodontist

NPI Registry JSON

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560211200000",
    "number": "1023221165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3268 WILD WEST LN",
            "city": "WELLINGTON",
            "state": "CO",
            "postal_code": "805491595",
            "telephone_number": "719-369-8122",
            "fax_number": "970-568-9938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8017 FIRST STREET #C",
            "city": "WELLINGTON",
            "state": "CO",
            "postal_code": "805491595",
            "telephone_number": "970-775-4504",
            "fax_number": "970-293-8303"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3529 E Grand Ave # 82070",
            "address_purpose": "LOCATION",
            "city": "Laramie",
            "state": "WY",
            "postal_code": "820705135",
            "country_code": "US",
            "telephone_number": "307-460-9099",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WESTPHAL",
        "first_name": "REGINALD",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-07",
        "last_updated": "2019-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "CO",
            "license": "100988",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellington, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.