Active NPI
Mark Allen Westphal, D.D.S.
- Dentist
- Scottsbluff, NE
National Provider Identifier
1528100765
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 5166
- Practice address
- 213 W 38TH St
Scottsbluff, NE 69361-4626 - Phone
- (308) 635-3232
- Fax
- (308) 635-2968
- NPI assigned
- Feb 13, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 5166 | NE | Primary |
Addresses
Primary practice location
213 W 38TH St
Scottsbluff, NE 69361-4626
Mailing address
213 W 38TH St
Scottsbluff, NE 69361-4626
Phone (308) 635-3232
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 47-0658545-01 | Medicaid | NE |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5166 | NE | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171324800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1528100765",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "213 W 38TH ST",
"city": "SCOTTSBLUFF",
"state": "NE",
"postal_code": "693614626",
"telephone_number": "308-635-3232",
"fax_number": "308-635-2968"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "213 W 38TH ST",
"city": "SCOTTSBLUFF",
"state": "NE",
"postal_code": "693614626",
"telephone_number": "308-635-3232",
"fax_number": "308-635-2968"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WESTPHAL",
"first_name": "MARK",
"middle_name": "ALLEN",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-13",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NE",
"license": "5166",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "47-0658545-01",
"state": "NE"
}
],
"endpoints": [],
"other_names": []
}Other providers in Scottsbluff, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.