Provider Demographics
NPI:1285844332
Name:WESTERMEYER, JOHN ROLAND (DDS)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:ROLAND
Last Name:WESTERMEYER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11900 LA MIRADA BLVD
Mailing Address - Street 2:SUITE 7
Mailing Address - City:LA MIRADA
Mailing Address - State:CA
Mailing Address - Zip Code:90638-1332
Mailing Address - Country:US
Mailing Address - Phone:562-947-3761
Mailing Address - Fax:562-947-3763
Practice Address - Street 1:11900 LA MIRADA BLVD
Practice Address - Street 2:SUITE 7
Practice Address - City:LA MIRADA
Practice Address - State:CA
Practice Address - Zip Code:90638-1332
Practice Address - Country:US
Practice Address - Phone:562-947-3761
Practice Address - Fax:562-947-3763
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA230621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice