Provider Demographics
NPI:1174871560
Name:WEST, KORY DAVID (DDS)
Entity type:Individual
Prefix:MR
First Name:KORY
Middle Name:DAVID
Last Name:WEST
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2801 TOWNSGATE RD STE 205
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91361-3024
Mailing Address - Country:US
Mailing Address - Phone:805-494-3231
Mailing Address - Fax:805-494-3241
Practice Address - Street 1:2801 TOWNSGATE RD STE 205
Practice Address - Street 2:
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91361-3024
Practice Address - Country:US
Practice Address - Phone:805-494-3231
Practice Address - Fax:805-494-3241
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-16
Last Update Date:2018-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901020799122300000X
CA102400122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist