Provider Demographics
NPI:1962676916
Name:WESTMOORE DENTAL STUDIO
Entity Type:Organization
Organization Name:WESTMOORE DENTAL STUDIO
Other - Org Name:JANET Y. HENDRICK, D.D.S.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JANET
Authorized Official - Middle Name:YORK
Authorized Official - Last Name:HENDRICK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:405-692-5800
Mailing Address - Street 1:11317 S WESTERN AVE
Mailing Address - Street 2:BUILDING 500
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73170
Mailing Address - Country:US
Mailing Address - Phone:405-692-5800
Mailing Address - Fax:405-692-4501
Practice Address - Street 1:11317 S WESTERN AVE
Practice Address - Street 2:BUILDING 500
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73170
Practice Address - Country:US
Practice Address - Phone:405-692-5800
Practice Address - Fax:405-692-4501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-21
Last Update Date:2020-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No122300000XDental ProvidersDentistGroup - Multi-Specialty