Provider Demographics
NPI:1558532309
Name:WESTENDORF, WILLIAM AUGUST SR (DDS,ND)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:AUGUST
Last Name:WESTENDORF
Suffix:SR
Gender:M
Credentials:DDS,ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2818 BLUE ROCK RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45239-6335
Mailing Address - Country:US
Mailing Address - Phone:513-218-3299
Mailing Address - Fax:513-741-0182
Practice Address - Street 1:2818 BLUE ROCK RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45239-6335
Practice Address - Country:US
Practice Address - Phone:513-218-3299
Practice Address - Fax:513-741-0182
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-20
Last Update Date:2008-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH13781122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist