Healthcare Provider Details

I. General information

NPI: 1558532309
Provider Name (Legal Business Name): WILLIAM AUGUST WESTENDORF SR. DDS,ND
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2008
Last Update Date: 03/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2818 BLUE ROCK RD
CINCINNATI OH
45239-6335
US

IV. Provider business mailing address

2818 BLUE ROCK RD
CINCINNATI OH
45239-6335
US

V. Phone/Fax

Practice location:
  • Phone: 513-218-3299
  • Fax: 513-741-0182
Mailing address:
  • Phone: 513-218-3299
  • Fax: 513-741-0182

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number13781
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: