MEDICARE: WESTERMANN FAMILY DENTISTRY PLLC

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	332BC3200X	Customized Equipment (DME)
2	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1649699513
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WESTERMANN FAMILY DENTISTRY PLLC

Provider Business Mailing Address
First Line	:	10212 WESTPORT RD
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40241-2148
Country	:	US
Telephone Number	:	502-426-1022
Fax Number	:	502-426-9385

Provider Business Practice Location Address
First Line	:	10212 WESTPORT RD
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40241-2148
Country	:	US
Telephone Number	:	502-426-1022
Fax Number	:	502-426-9385

Authorized Official
Title or Position	:	OWNER
Name	:	KIMBERLY J WESTERMANN
Credential	:	DMD
Telephone Number	:	502-426-1022

Provider Enumeration Date	:	04/08/2014
Last Update Date	:	03/19/2025

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