Provider Demographics
NPI:1538365960
Name:WEST, VANESSA L (DDS)
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:L
Last Name:WEST
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2955 N MOORPARK RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360-4568
Mailing Address - Country:US
Mailing Address - Phone:805-492-5050
Mailing Address - Fax:805-436-1217
Practice Address - Street 1:2955 N MOORPARK RD
Practice Address - Street 2:SUITE B
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-4568
Practice Address - Country:US
Practice Address - Phone:805-492-5050
Practice Address - Fax:805-436-1217
Is Sole Proprietor?:No
Enumeration Date:2007-06-22
Last Update Date:2009-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI22991223G0001X
CA58138122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice