Randolph Robert West, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

23888 Issued in TX

Practice address

295 W. Byron Nelson Blvd.
Suite 228
Roanoke, TX 76262-3190

Phone

(682) 831-9994

Fax

(682) 831-9996

NPI assigned

Jun 27, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1214524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473292800000",
    "number": "1447412812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "295 W. BYRON NELSON BLVD.",
            "address_2": "SUITE 228",
            "city": "ROANOKE",
            "state": "TX",
            "postal_code": "762623190",
            "telephone_number": "682-831-9994",
            "fax_number": "682-831-9996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "295 W. BYRON NELSON BLVD.",
            "address_2": "SUITE 228",
            "city": "ROANOKE",
            "state": "TX",
            "postal_code": "762623190",
            "telephone_number": "682-831-9994",
            "fax_number": "682-831-9996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEST",
        "first_name": "RANDOLPH",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-27",
        "last_updated": "2016-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "23888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wal-Mart Stores Texas, LLC (Wal-Mart Vision Center 30-5247)
• William Walker, M.ED., L.P.C.
• Darcy Taras Walter, RN
• Kantana NMN Watson
• Lori D West, LPC-A
• Aimee Nicole Williams, SLP
• Beverly Ann Williams
• Nicholas Levi Wohlers, DC
• WTR Services LLC (Doctors' Mobile X-Ray)
• Kyung Ah Karen Yoo

• General Practice Dentistry in Roanoke, TX
• Providers in Roanoke, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.