Jillian Skeeters Woodruff DMD, PA

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

JILLIAN SKEETERS WOODRUFF DMD, PA

Doing business as

Concord Center for Family Dentistry

Practice address

982 Lee Ann Dr NE
Concord, NC 28025-2957

Phone

(704) 787-9355

Fax

(704) 787-9554

NPI assigned

Dec 1, 2020

Organization subpart

No

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

Authorized official

Name

Jillian Skeeters Woodruff, DMD

Title

Dentist/Owner

Phone

(704) 787-9355

Specialties & licenses 1

Addresses

Other names 1

• Concord Center for Family Dentistry Doing business as

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

{
    "created_epoch": "1606780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610323200000",
    "number": "1215532817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19407 META RD",
            "city": "CORNELIUS",
            "state": "NC",
            "postal_code": "280317543",
            "telephone_number": "615-517-7017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "982 LEE ANN DR NE",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252957",
            "telephone_number": "704-787-9355",
            "fax_number": "704-787-9554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JILLIAN SKEETERS WOODRUFF DMD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-01",
        "last_updated": "2021-01-11",
        "certification_date": "2021-01-11",
        "status": "A",
        "authorized_official_last_name": "WOODRUFF",
        "authorized_official_first_name": "JILLIAN",
        "authorized_official_middle_name": "SKEETERS",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "704-787-9355",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Concord Center for Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Schwanna Denise Jenkins, LCSWA
• Blake Jennewein
• Dana Elzayat Jeter
• Latifah Quanah Jeter, FNP-C
• Amy Jewell, LCSW
• Priscila Jimenez
• Carrie Jirka
• John E. Kempter DDS PLLC
• John Edward Kempter DDS PLLC
• Apu Amanda Johnson Seyenkulo, DPT

• General Practice Dentistry in Concord, NC
• Providers in Concord, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2021; 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.