David Stanley Wozniak, ENDODONTIST DDS

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

0401005665 Issued in VA

Practice address

12040 W. Broad Street
Henrico, VA 23233

Phone

(804) 364-7010

Fax

(804) 419-1059

NPI assigned

Apr 24, 2007

Last updated

Sep 21, 2021By the provider in NPPES

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

Other names 1

• David S Wozniak Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Sep 23, 2016 through Sep 23, 2026

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Provision Eye Care, LLC

  • Optometrist
  • Glen Allen, VA
  • NPI 1306379003
  NPD (past)
• Virginia Family Dentistry PC

  • General Practice Dentistry
  • Midlothian, VA
  • NPI 1750435970
  NPD (past)

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632182400000",
    "number": "1194944884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1612 HUGUENOT RD",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "23113",
            "telephone_number": "804-794-9789",
            "fax_number": "804-419-1059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12040 W. BROAD STREET",
            "city": "HENRICO",
            "state": "VA",
            "postal_code": "23233",
            "telephone_number": "804-364-7010",
            "fax_number": "804-419-1059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOZNIAK",
        "first_name": "DAVID",
        "middle_name": "STANLEY",
        "name_prefix": "Dr.",
        "credential": "ENDODONTIST DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-24",
        "last_updated": "2021-09-21",
        "certification_date": "2021-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "VA",
            "license": "0401005665",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DAVID",
            "last_name": "WOZNIAK",
            "middle_name": "S",
            "credential": "DDS MS",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Chanda Woods
• Mary E. Woods, LCSW
• Alissa Anne Woolfolk
• Workit Health Mi PLLC
• Charles Little Worthington III, PHARMD
• Jerri Noel Wright
• Laneda L. Wright
• Mesmerize U Wright, CLMT, CLT
• Diem N Wu, M.D.
• Wyndell H Merritt MD PC

• Endodontics in Henrico, VA
• Providers in Henrico, VA by specialty
• Endodontics in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2021; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.