Westgate Periodontics, PLLC

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

D008400 Issued in AZ

Legal business name

WESTGATE PERIODONTICS, PLLC

Practice address

6535 W Camelback Rd
Suite #1
Phoenix, AZ 85033-1608

Phone

(623) 848-1901

Fax

(623) 848-8778

NPI assigned

May 20, 2016

Organization subpart

No

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

Authorized official

Name

Kurt D Wallin, D.M.D.

Title

Owner/Dentist

Phone

(623) 848-1901

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1463702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463702400000",
    "number": "1073960928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6535 W CAMELBACK RD",
            "address_2": "SUITE #1",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850331608",
            "telephone_number": "623-848-1901",
            "fax_number": "623-848-8778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6535 W CAMELBACK RD",
            "address_2": "SUITE #1",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850331608",
            "telephone_number": "623-848-1901",
            "fax_number": "623-848-8778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTGATE PERIODONTICS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-20",
        "last_updated": "2016-05-20",
        "status": "A",
        "authorized_official_last_name": "WALLIN",
        "authorized_official_first_name": "KURT",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "623-848-1901",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": "AZ",
            "license": "D008400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Orme Westfall, M.D.
• Laura Ann Westfall, FNP
• Westfam Sa de CV PC
• Westgate Dental Partners LLC
• Westgate Pediatric Dental Partners LLC
• Amanda Westlake, PMHNP, MSN
• Tracy Westlake, MD
• Craig Alan Westley
• James Westly, MC, LPC
• Melissa Westman

• Periodontics in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Periodontics in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 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.