Individual provider Active NPI

Thomas Franklin Woodruff, DDS

  • General Practice Dentistry
  • Tucson, AZ
National Provider Identifier
1205835956
Registry record updated Mar 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D009858 Issued in AZ
Practice address
3690 S Park Ave Ste 805
Tucson, AZ 85713-5042
Phone
(520) 616-6760
Fax
(520) 616-6799
NPI assigned
Jul 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D009858 AZ Primary
Dentist 122300000X 30016510 OH

Addresses

Primary practice location

3690 S Park Ave Ste 805
Tucson, AZ 85713-5042

Mailing address

PO Box 188
Marana, AZ 85653-0188
Phone (520) 682-4111

Other identifiers 1

IdentifierTypeStateIssuer
335318MedicaidAZ

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180111001130 AZ Practitioner - Oral Surgery 4082973342 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30016510OHMDDentist
D009858AZMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Marana Health Center, Inc Dentist CurrentSince Jan 2, 2018 Accepting new patients
Marana Health Center Inc CurrentSince Jan 2, 2018 Accepting new patients
Marana Health Center, Inc Past Accepting new patients

Locations

13395 N Marana Main St
Marana, AZ 85653
Phone (520) 616-6200

2945 W Ina Rd
Ste 103
Tucson, AZ 85741
Phone (520) 289-8018

3690 S Park Ave
Ste 805
Tucson, AZ 85713
Phone (520) 616-1560

1670 W Ruthrauff Rd
Tucson, AZ 85705
Phone (520) 616-6797

899 N Wilmot Rd
Bldg E
Tucson, AZ 85711
Phone (520) 616-1542

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1121385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522195200000",
    "number": "1205835956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 188",
            "city": "MARANA",
            "state": "AZ",
            "postal_code": "856530188",
            "telephone_number": "520-682-4111",
            "fax_number": "520-818-3630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3690 S PARK AVE STE 805",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857135042",
            "telephone_number": "520-616-6760",
            "fax_number": "520-616-6799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODRUFF",
        "first_name": "THOMAS",
        "middle_name": "FRANKLIN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-15",
        "last_updated": "2018-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D009858",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30016510",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "335318",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.