Provider Demographics
NPI:1215318779
Name:WEST, KAITLYN O'CONNELL (DMD)
Entity type:Individual
Prefix:
First Name:KAITLYN
Middle Name:O'CONNELL
Last Name:WEST
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 GRIFFIN RD STE 1
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-7131
Mailing Address - Country:US
Mailing Address - Phone:603-436-2204
Mailing Address - Fax:
Practice Address - Street 1:150 GRIFFIN RD STE 1
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-7131
Practice Address - Country:US
Practice Address - Phone:603-436-2204
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-10
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH048341223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty