Provider Demographics
NPI:1801815683
Name:WESTBROOK, DONALD LEIGH (DDS)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:LEIGH
Last Name:WESTBROOK
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 1:3708 SYMI CIR
Mailing Address - Street 2:
Mailing Address - City:MOREHEAD CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28557-4309
Mailing Address - Country:US
Mailing Address - Phone:252-726-5778
Mailing Address - Fax:252-726-2684
Practice Address - Street 1:3708 SYMI CIR
Practice Address - Street 2:
Practice Address - City:MOREHEAD CITY
Practice Address - State:NC
Practice Address - Zip Code:28557-4309
Practice Address - Country:US
Practice Address - Phone:252-726-5778
Practice Address - Fax:252-726-2684
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC38421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8999145Medicaid
NC8999145Medicaid