Provider Demographics
NPI:1952995821
Name:NATHAN WEST DMD PLLC
Entity Type:Organization
Organization Name:NATHAN WEST DMD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WEST
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:210-788-9008
Mailing Address - Street 1:2669 E HAMPTON LN
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85295-2335
Mailing Address - Country:US
Mailing Address - Phone:210-788-9008
Mailing Address - Fax:
Practice Address - Street 1:3220 S GILBERT RD STE 1
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85286-5109
Practice Address - Country:US
Practice Address - Phone:480-802-2200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-22
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty