Active NPI
Brock B Westover, D.D.S., M.ED.
- Prosthodontics
- San Fernando, CA
National Provider Identifier
1700949518
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthodontics
- License
- 61337
- Practice address
- 1101 Truman St
San Fernando, CA 91340-3237 - Phone
- (714) 571-3672
- NPI assigned
- Dec 19, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthodontics | 1223P0700X | 2516-89 | MS | |
| Prosthodontics | 1223P0700X | 61337 | CA | Primary |
Addresses
Primary practice location
1101 Truman St
San Fernando, CA 91340-3237
Mailing address
338 Hillview Dr
Ridgeland, MS 39157-8606
Phone (601) 214-6282
Other practice location 1
338 Hillview Dr
Ridgeland, MS 39157-8606
Phone (601) 214-6282
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 72-1343206 | Other | MS | T.I.N. |
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
- Credentials
- Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 61337 | CA | MD | Prosthodontist |
| 2516-89 | MS | MD | Prosthodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166486400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1636675200000",
"number": "1700949518",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "338 HILLVIEW DR",
"city": "RIDGELAND",
"state": "MS",
"postal_code": "391578606",
"telephone_number": "601-214-6282"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1101 TRUMAN ST",
"city": "SAN FERNANDO",
"state": "CA",
"postal_code": "913403237",
"telephone_number": "714-571-3672"
}
],
"practiceLocations": [
{
"address_1": "338 Hillview Dr",
"address_purpose": "LOCATION",
"city": "Ridgeland",
"state": "MS",
"postal_code": "391578606",
"country_code": "US",
"telephone_number": "601-214-6282",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WESTOVER",
"first_name": "BROCK",
"middle_name": "B",
"name_prefix": "Dr.",
"credential": "D.D.S., M.ED.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-19",
"last_updated": "2021-11-12",
"certification_date": "2021-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0700X",
"taxonomy_group": "",
"desc": "Dentist, Prosthodontics",
"state": "MS",
"license": "2516-89",
"primary": false
},
{
"code": "1223P0700X",
"taxonomy_group": "",
"desc": "Dentist, Prosthodontics",
"state": "CA",
"license": "61337",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "T.I.N.",
"identifier": "72-1343206",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Fernando, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.