Jacob D Woodward, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

102639 Issued in CA

Practice address

1269 Pleasant Grove Blvd Ste 100
Roseville, CA 95747-5885

Phone

(916) 786-4865

NPI assigned

Jun 27, 2018

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Guthrie Ahc

  dba Usadc Stone-Drum

  • Military/U.S. Coast Guard Outpatient Clinic/Center
  • Fort Drum, NY
  • NPI 1740486091
  NPD (past)

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

{
    "created_epoch": "1530057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661212800000",
    "number": "1134614563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1269 PLEASANT GROVE BLVD STE 100",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "957475885",
            "telephone_number": "916-786-4865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1269 PLEASANT GROVE BLVD STE 100",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "957475885",
            "telephone_number": "916-786-4865"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4420 Town Center Blvd",
            "address_purpose": "LOCATION",
            "city": "El Dorado Hills",
            "state": "CA",
            "postal_code": "957627134",
            "country_code": "US",
            "telephone_number": "916-358-8722",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOODWARD",
        "first_name": "JACOB",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-27",
        "last_updated": "2022-08-23",
        "certification_date": "2022-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "102639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Mae Woodhouse, RN
• Chinelle Woodley
• Lori A Woods, CADC- II
• Sheree Woods, SLP
• Christine M Woodward, RD
• Skylar Woolman
• Steven J. Workman, MD
• Kathleen Sun Worrall, DPT
• Sydney Worthy
• Jakob Michael Wrate

• General Practice Dentistry in Roseville, CA
• Providers in Roseville, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2022; 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.