Randol Olen Woolbright Jr., D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12008633A Issued in IN

Practice address

214 E McClain Ave
Scottsburg, IN 47170-1824

Phone

(812) 752-7745

Fax

(812) 752-5543

NPI assigned

Mar 21, 2007

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053437012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 E MCCLAIN AVE",
            "city": "SCOTTSBURG",
            "state": "IN",
            "postal_code": "471701824",
            "telephone_number": "812-752-7745",
            "fax_number": "812-752-5543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 E MCCLAIN AVE",
            "city": "SCOTTSBURG",
            "state": "IN",
            "postal_code": "471701824",
            "telephone_number": "812-752-7745",
            "fax_number": "812-752-5543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOLBRIGHT",
        "first_name": "RANDOL",
        "middle_name": "OLEN",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12008633A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100221370A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Evan West, PHARMD
• Ronald Lynn West, R.PH
• Lisa Whittaker, LCSW
• Elijah Shay Wilkin, PHARMD
• Garrett Lee Wilson, DMD
• David Yeager
• Noreen Elaine Young, MS, RD, LD
• Debra Marie Zimmer, FNP-C
• Brenda Joyce Zollman, RN

• General Practice Dentistry in Scottsburg, IN
• Providers in Scottsburg, IN by specialty
• General Practice Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.