Provider Demographics
NPI:1508499567
Name:WESTLAKE ENDODONTICS LLC
Entity Type:Organization
Organization Name:WESTLAKE ENDODONTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ENDODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ANAS
Authorized Official - Middle Name:
Authorized Official - Last Name:FATAYER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:412-390-8541
Mailing Address - Street 1:1918 GEORGETOWN DR
Mailing Address - Street 2:
Mailing Address - City:SEWICKLEY
Mailing Address - State:PA
Mailing Address - Zip Code:15143-6504
Mailing Address - Country:US
Mailing Address - Phone:412-390-8510
Mailing Address - Fax:
Practice Address - Street 1:30400 DETROIT RD STE 209
Practice Address - Street 2:
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-1855
Practice Address - Country:US
Practice Address - Phone:412-407-2723
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-18
Last Update Date:2020-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental