Individual provider Active NPI

Thomas E. Westbrook Jr., DR.

  • General Practice Dentistry
  • Blytheville, AR
National Provider Identifier
1811022692
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
AR2415 Issued in AR
Practice address
507 Hutson St
Blytheville, AR 72315-2415
Phone
(870) 762-5274
Fax
(870) 762-5280
NPI assigned
Feb 22, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X AR2415 AR Primary

Addresses

Primary practice location

507 Hutson St
Blytheville, AR 72315-2415

Mailing address

507 Hutson St
Blytheville, AR 72315-2415
Phone (870) 762-5274

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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

Enrollment IDStateProvider typePAC IDDetails
I20180302000596 AR Order and Referring Only - DentistPractitioner - Dentist 4385905512

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AR2415ARMDGeneral Practice Dentistry
2415ARMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Alayna Hattenhauer DDS PLLC PastSince Jul 24, 2022 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1811022692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "507 HUTSON ST",
            "city": "BLYTHEVILLE",
            "state": "AR",
            "postal_code": "723152415",
            "telephone_number": "870-762-5274",
            "fax_number": "870-762-5280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "507 HUTSON ST",
            "city": "BLYTHEVILLE",
            "state": "AR",
            "postal_code": "723152415",
            "telephone_number": "870-762-5274",
            "fax_number": "870-762-5280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WESTBROOK",
        "first_name": "THOMAS",
        "middle_name": "E.",
        "name_suffix": "Jr.",
        "credential": "DR.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "AR2415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blytheville, AR

Sources for this page

Verify at the official NPI Registry.