Matthew Louis Westerberg, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

19612 Issued in TX

Practice address

935 Eventide Dr
San Antonio, TX 78209-5559

Phone

(210) 824-9566

Fax

(210) 824-9975

NPI assigned

Feb 15, 2006

Sex

Male

Sole proprietor

Yes

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

State licenses

Practice roles

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.

• Ivy Lane Dentistry

  • General Practice Dentistry
  • San Antonio, TX
  • NPI 1467539577
  NPD (past) Authorized official

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

{
    "created_epoch": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629042874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 TUTTLE RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782096145",
            "telephone_number": "210-824-9566",
            "fax_number": "210-824-9566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "935 EVENTIDE DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782095559",
            "telephone_number": "210-824-9566",
            "fax_number": "210-824-9975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WESTERBERG",
        "first_name": "MATTHEW",
        "middle_name": "LOUIS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "19612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kellie Westbrook, STA
• Steven D Westbrook, DMD
• Victoria Anne Westbrook, LPC
• Kelly Westbrooks
• Zack Westenhaver
• Paul W Westerberg, R.PH.
• Sandra Lydia Westerberg, RPH
• Meghan Leigh Westerman, LPC
• Western Dental Care
• Alicia Westfall, RD, LD

• Dentist in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.