Individual provider Active NPI

Keith E. Wester, D.D.S.

  • General Practice Dentistry
  • Portage, MI
National Provider Identifier
1124142377
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D15368 Issued in MI
Practice address
8191 Moors Bridge Rd
Portage, MI 49024-7416
Phone
(269) 327-1119
Fax
(269) 327-5725
NPI assigned
Mar 16, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D15368 MI Primary

Addresses

Primary practice location

8191 Moors Bridge Rd
Portage, MI 49024-7416

Mailing address

8191 Moors Bridge Rd
Portage, MI 49024-7416
Phone (269) 327-1119

Other identifiers 2

IdentifierTypeStateIssuer
666305OtherMIUNITED CONCORDIA
D15368OtherMIBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170512001642 MI Order and Referring Only - DentistPractitioner - Dentist 5496834574

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D15368MIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Wester Dental Care, P.C. General Practice 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.

NPI Registry JSON

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124142377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8191 MOORS BRIDGE RD",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490247416",
            "telephone_number": "269-327-1119",
            "fax_number": "269-327-5725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8191 MOORS BRIDGE RD",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490247416",
            "telephone_number": "269-327-1119",
            "fax_number": "269-327-5725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WESTER",
        "first_name": "KEITH",
        "middle_name": "E.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "D15368",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "666305",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "D15368",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portage, MI

Sources for this page

Verify at the official NPI Registry.