Active NPI
Nathan George Woods, DDS
- Endodontics
- Mesa, AZ
National Provider Identifier
1093909509
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- D07243
- Practice address
- 2855 E Brown Rd
Suite 15
Mesa, AZ 85213-4213 - Phone
- (804) 814-5801
- NPI assigned
- Aug 29, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | D6409 | LA | |
| Endodontics | 1223E0200X | DD4658 | NM | |
| General Practice Dentistry | 1223G0001X | D07243 | AZ | |
| Endodontics | 1223E0200X | D07243 | AZ | Primary |
Addresses
Primary practice location
2855 E Brown Rd
Suite 15
Mesa, AZ 85213-4213
Mailing address
2855 E Brown Rd
Suite 15
Mesa, AZ 85213-4213
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170811002166 | AZ | Order and Referring Only - Other (Physician) | 7810268646 |
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2020
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1706 Timber Oak St
San Antonio, TX 78232-4432
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D6409 | LA | MD | Dentist |
| D07243 | AZ | MD | Endodontist |
| DD4658 | NM | MD | Endodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1188345600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1498348800000",
"number": "1093909509",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2855 E BROWN RD",
"address_2": "SUITE 15",
"city": "MESA",
"state": "AZ",
"postal_code": "852134213"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2855 E BROWN RD",
"address_2": "SUITE 15",
"city": "MESA",
"state": "AZ",
"postal_code": "852134213",
"telephone_number": "804-814-5801"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOODS",
"first_name": "NATHAN",
"middle_name": "GEORGE",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-08-29",
"last_updated": "2017-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "LA",
"license": "D6409",
"primary": false
},
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "NM",
"license": "DD4658",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "AZ",
"license": "D07243",
"primary": false
},
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "AZ",
"license": "D07243",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2017; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.