Westphalia Dental Care, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

14531 Issued in MD

Legal business name

WESTPHALIA DENTAL CARE, LLC

Practice address

9632 Marlboro Pike
Upper Marlboro, MD 20772

Phone

(240) 838-7568

Fax

(301) 576-5800

NPI assigned

Jul 15, 2014

Last updated

Jul 15, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Mark Van Russell

Title

VP of Operations

Phone

(240) 320-7331

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1405382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405382400000",
    "number": "1891102554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9632 MARLBORO PIKE",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "20772",
            "telephone_number": "240-838-7568",
            "fax_number": "301-576-5800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9632 MARLBORO PIKE",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "20772",
            "telephone_number": "240-838-7568",
            "fax_number": "301-576-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTPHALIA DENTAL CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-15",
        "last_updated": "2014-07-15",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "VAN",
        "authorized_official_title_or_position": "VP OF OPERATIONS",
        "authorized_official_telephone_number": "240-320-7331",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "14531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Milian Wenong
• Cherry West
• Nyala West
• Farah A Westbrook, MA, NCC, LPC, LCPC
• Hannah Westman
• Rakia Westry, CCC-SLP
• Helen Delores Whitaker-Thompson
• Dine White, LCPC
• Nicole C White
• Ramona White, NP

• General Practice Dentistry in Upper Marlboro, MD
• Providers in Upper Marlboro, MD by specialty
• General Practice Dentistry in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2014; 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.