Kirk Woodruff, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

PD0019 Issued in AZ

Practice address

18550 E Rittenhouse Rd Ste 103
Queen Creek, AZ 85142-4599

Phone

(480) 840-3005

NPI assigned

Jul 2, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1593648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593648000000",
    "number": "1053938373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18550 E RITTENHOUSE RD STE 103",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851424599",
            "telephone_number": "480-840-3005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18550 E RITTENHOUSE RD STE 103",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851424599",
            "telephone_number": "480-840-3005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODRUFF",
        "first_name": "KIRK",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-02",
        "last_updated": "2020-07-02",
        "certification_date": "2020-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "PD0019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ambrey Frazier Wolfley, LMT
• Kolby R Wolfley, DC
• Women'S Health Now PLLC
• Amanda Beth Wood, EDD, SLPA
• Kenneth Scott Woodall, PHARMD
• Rickey Woolfolk
• Renee M Wozniak, PH.D,BCBA
• Jennifer C Wright-Bennion, CNM
• Delaney R Wright
• Lorraine Wright, SLPA

• General Practice Dentistry in Queen Creek, AZ
• Providers in Queen Creek, AZ by specialty
• General Practice Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.