Healthcare Provider Details

I. General information

NPI: 1790900728
Provider Name (Legal Business Name): WESTWOOD DENTAL GROUP PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3190 S WADSWORTH BLVD SUITE 300
LAKEWOOD CO
80227-4899
US

IV. Provider business mailing address

3190 S WADSWORTH BLVD SUITE 300
LAKEWOOD CO
80227-4899
US

V. Phone/Fax

Practice location:
  • Phone: 303-988-6110
  • Fax: 303-988-8307
Mailing address:
  • Phone: 303-988-6110
  • Fax: 303-988-8307

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number8078
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number6596
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number3105
License Number StateCO
# 4
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number6565
License Number StateCO
# 5
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number3316
License Number StateCO

VIII. Authorized Official

Name: GUY F GRABIAK
Title or Position: PARTNER
Credential: D.M.D.
Phone: 303-988-6110