1568755536 NPI number — DR. JONAS KILMER WESTBROOK D.D.S.

Table of content: DR. JONAS KILMER WESTBROOK D.D.S. (NPI 1568755536)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1568755536 NPI number — DR. JONAS KILMER WESTBROOK D.D.S.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WESTBROOK
Provider First Name:
JONAS
Provider Middle Name:
KILMER
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.D.S.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1568755536
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/05/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5 COMMERCE WAY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BARRINGTON
Provider Business Mailing Address State Name:
NH
Provider Business Mailing Address Postal Code:
03825
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
603-664-2722
Provider Business Mailing Address Fax Number:
603-664-5461

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5 COMMERCE WAY
Provider Second Line Business Practice Location Address:
APPLEWOOD FAMILY DENTISTRY
Provider Business Practice Location Address City Name:
BARRINGTON
Provider Business Practice Location Address State Name:
NH
Provider Business Practice Location Address Postal Code:
03825
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
603-604-2722
Provider Business Practice Location Address Fax Number:
603-664-5461
Provider Enumeration Date:
05/24/2011

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  NH04197 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: DEN4180 . This is a "MAINE BOARD OF DENTAL EXAMINERS LICENSE" identifier , issued by the state of ( ME ) . This identifiers is of the category "OTHER".




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