Western Dental Group of Academy Blvd

Primary specialty

Oral and Maxillofacial Pathology DentistryTaxonomy code 1223P0106X

License

7181 Issued in CO

Legal business name

WESTERN DENTAL GROUP OF ACADEMY BLVD

Doing business as

Academy Blvd Oral Surgery

Practice address

1304 N Academy Blvd
Suite 205
Colorado Springs, CO 80909-3325

Phone

(719) 596-8440

Fax

(719) 572-8934

NPI assigned

Mar 29, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Leopoldo Rodriguez, D.D.S.

Title

Owner

Phone

(719) 596-3939

Specialties & licenses 1

Addresses

Other names 1

• Academy Blvd Oral Surgery Doing business as

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1649390220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1304 N ACADEMY BLVD",
            "address_2": "SUITE 205",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809093325",
            "telephone_number": "719-596-8440",
            "fax_number": "719-572-8934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1304 N ACADEMY BLVD",
            "address_2": "SUITE 205",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809093325",
            "telephone_number": "719-596-8440",
            "fax_number": "719-572-8934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN DENTAL GROUP OF ACADEMY BLVD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ",
        "authorized_official_first_name": "LEOPOLDO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "719-596-3939",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223P0106X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "CO",
            "license": "7181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Academy Blvd Oral Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Heather Westbrook, LCSW
• Jenna Westby
• Jonathan Eric Westcot, D.O.
• Heather Westenburg, NP
• Westephealth Care, Inc (Preferred Care at Home of Colorado Springs)
• Western States Neuromonitoring Services, LLC
• Western States Optical, Inc. (Pearle Vision Eyecare of Colorado Springs)
• Carley Danielle Westerson, LPC
• Justine Westervelt
• Alisha Michelle Westfall

• Oral and Maxillofacial Pathology Dentistry in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Oral and Maxillofacial Pathology Dentistry in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.