MEDICARE: DR. DANIELLE ELIZABETH WEST 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	1223P0221X	Pediatric Dentistry	2018018442	MO
2	1223P0221X	Pediatric Dentistry	DN1859711	MA
3	1223P0221X	Pediatric Dentistry	05181	NH
4	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1902342579
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIELLE ELIZABETH WEST DDS

Provider Business Mailing Address
First Line	:	29 COUNTRY CLUB WAY
Second Line	:
City	:	IPSWICH
State	:	MA
Zip	:	01938-3000
Country	:	US
Telephone Number	:	573-631-4346
Fax Number	:

Provider Business Practice Location Address
First Line	:	150 GRIFFIN RD STE 1
Second Line	:
City	:	PORTSMOUTH
State	:	NH
Zip	:	03801-7131
Country	:	US
Telephone Number	:	603-436-2204
Fax Number	:

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

Provider Enumeration Date	:	01/06/2017
Last Update Date	:	01/16/2026

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