Jon M. Woodruff, D.D.S.;P.a.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6814 Issued in KS

Legal business name

JON M. WOODRUFF, D.D.S.;P.A.

Practice address

910 S Hillside St
Wichita, KS 67211-4001

Phone

(316) 684-7531

Fax

(316) 684-1824

NPI assigned

May 22, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Jon Michael Woodruff, D.D.S.

Title

Owner/President

Phone

(316) 684-7531

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1083668933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 S HILLSIDE ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672114001",
            "telephone_number": "316-684-7531",
            "fax_number": "316-684-1824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 S HILLSIDE ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672114001",
            "telephone_number": "316-684-7531",
            "fax_number": "316-684-1824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JON M. WOODRUFF, D.D.S.;P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WOODRUFF",
        "authorized_official_first_name": "JON",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "316-684-7531",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "KS",
            "license": "6814",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF KS",
            "identifier": "017363",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mia Johnston
• Sarah C Johnston, M.D.
• Tamara Leaann Johnston, LMSW, LMAC
• Taylor Johnston, MA, CCC-SLP
• Joint Academy Physical Therapy of KS PA
• Jonas a. Lichty DDS MD PA
• Karin Markey Jonas, LPC
• Murphy Lynne Jonas
• Patrick Jonas
• Jondoh House LLC

• General Practice Dentistry in Wichita, KS
• Providers in Wichita, KS by specialty
• General Practice Dentistry in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.