Provider Demographics
NPI:1679741458
Name:WESTCLIFF DENTAL, P.A.
Entity type:Organization
Organization Name:WESTCLIFF DENTAL, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:E
Authorized Official - Last Name:TAFEL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:214-883-4285
Mailing Address - Street 1:2231 W LEDBETTER DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75224-4740
Mailing Address - Country:US
Mailing Address - Phone:214-883-4285
Mailing Address - Fax:
Practice Address - Street 1:2231 W LEDBETTER DR
Practice Address - Street 2:SUITE 100
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75224-4740
Practice Address - Country:US
Practice Address - Phone:214-883-4285
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-14
Last Update Date:2008-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX155784502Medicaid
TX155784506Medicaid
TX155784503Medicaid
TX155784504Medicaid
TX155784505Medicaid