Provider Demographics
NPI:1750804274
Name:WESTPHAL, ERIK CHARLES (DDS)
Entity type:Individual
Prefix:DR
First Name:ERIK
Middle Name:CHARLES
Last Name:WESTPHAL
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 1:2811 N VALLEJO ST
Mailing Address - Street 2:APT. #305
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80211
Mailing Address - Country:US
Mailing Address - Phone:908-229-1503
Mailing Address - Fax:
Practice Address - Street 1:15151 E 104TH AVE STE 103
Practice Address - Street 2:
Practice Address - City:COMMERCE CITY
Practice Address - State:CO
Practice Address - Zip Code:80022-8948
Practice Address - Country:US
Practice Address - Phone:303-287-7000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-18
Last Update Date:2017-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN.002032001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice