NPIMap

Organization Active NPI

Cottonwood Dental Associates PLLC

  • Dentist
  • Cottonwood, AZ
National Provider Identifier
1043678055
Registry record updated Feb 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D03477 Issued in AZ
Legal business name
COTTONWOOD DENTAL ASSOCIATES PLLC
Practice address
830 S Main St
Suite 1 D
Cottonwood, AZ 86326-4620
Phone
(928) 634-5566
Fax
(928) 634-1363
NPI assigned
Feb 4, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2016

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

Authorized official

Name
Dr. Bruce Edwin Westover, DDSNPI 1659573087
Title
Owner/Dentist
Phone
(928) 634-5566

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X D03477 AZ Primary

Addresses

Primary practice location

830 S Main St
Suite 1 D
Cottonwood, AZ 86326-4620

Mailing address

830 S Main St
Suite 1 D
Cottonwood, AZ 86326-4620
Phone (928) 634-5566

Other identifiers 2

IdentifierTypeStateIssuer
1659573087OtherAZINDIVIDUAL NPI
D03477OtherAZDENTAL LICENSE

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1454544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454544000000",
    "number": "1043678055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 S MAIN ST",
            "address_2": "SUITE 1 D",
            "city": "COTTONWOOD",
            "state": "AZ",
            "postal_code": "863264620",
            "telephone_number": "928-634-5566",
            "fax_number": "928-634-1363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 S MAIN ST",
            "address_2": "SUITE 1 D",
            "city": "COTTONWOOD",
            "state": "AZ",
            "postal_code": "863264620",
            "telephone_number": "928-634-5566",
            "fax_number": "928-634-1363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COTTONWOOD DENTAL ASSOCIATES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-04",
        "last_updated": "2016-02-04",
        "status": "A",
        "authorized_official_last_name": "WESTOVER",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "EDWIN",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "928-634-5566",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "AZ",
            "license": "D03477",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1659573087",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL LICENSE",
            "identifier": "D03477",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cottonwood, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2016; 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.