MEDICARE: DR. NASJA ZDENKA WESKE DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	112651	CA
2	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1033916598
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NASJA ZDENKA WESKE DDS

Provider Business Mailing Address
First Line	:	4312 VALETA ST
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92107-1510
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	11301 WILSHIRE BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90073-1003
Country	:	US
Telephone Number	:	310-478-3711
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/03/2025
Last Update Date	:	01/21/2026

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