Kendall Sherron Woolridge, D.D.S.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

57096 Issued in CA

Practice address

310 E Grand Ave Ste 106
El Segundo, CA 90245-3871

Phone

(310) 648-8781

Fax

(661) 648-8776

NPI assigned

Nov 7, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kwoolridge@direct.westerndental.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Kendall S Woolridge D,D,S PC

  dba Grand Orthodontics

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • El Segundo, CA
  • NPI 1609149533
  NPD Authorized official

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

{
    "created_epoch": "1194393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437004800000",
    "number": "1104006196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 E GRAND AVE STE 106",
            "city": "EL SEGUNDO",
            "state": "CA",
            "postal_code": "902453871",
            "telephone_number": "310-648-8781",
            "fax_number": "661-648-8776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 E GRAND AVE STE 106",
            "city": "EL SEGUNDO",
            "state": "CA",
            "postal_code": "902453871",
            "telephone_number": "310-648-8781",
            "fax_number": "661-648-8776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOLRIDGE",
        "first_name": "KENDALL",
        "middle_name": "SHERRON",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-07",
        "last_updated": "2015-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NY",
            "license": "053717",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "57096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kalimah Woodson
• Shyann Woodstone
• Dana Woodward
• Kendall Woodward
• Madeleine Woodward
• Elizabeth Wooster
• Jamiya Wooten
• Lucy Whetstone Worden
• Savanna Raine Wormley
• Zantaria Wray

• Orthodontics and Dentofacial Orthopedics Dentistry in El Segundo, CA
• Providers in El Segundo, CA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2015; 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.