McKenna Jo Woodward, DDS

Primary specialty

Public Health DentistryTaxonomy code 1223D0001X

License

DDS-09995 Issued in IA

Practice address

1210 4TH Ave SE
Cedar Rapids, IA 52403-4085

Phone

(319) 730-7300

NPI assigned

Jun 14, 2022

Last updated

Apr 9, 2024By the provider in NPPES

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

Other names 1

• McKenna Jo Kilburg Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1655164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712620800000",
    "number": "1245960012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1210 4TH AVE SE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524034085",
            "telephone_number": "319-730-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 4TH AVE SE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524034085",
            "telephone_number": "319-730-7300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4332 Center Point Rd NE",
            "address_purpose": "LOCATION",
            "city": "Cedar Rapids",
            "state": "IA",
            "postal_code": "524023181",
            "country_code": "US",
            "telephone_number": "319-365-4997",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOODWARD",
        "first_name": "MCKENNA",
        "middle_name": "JO",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-14",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "DDS-09995",
            "primary": false
        },
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "IA",
            "license": "DDS-09995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MCKENNA",
            "last_name": "KILBURG",
            "middle_name": "JO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Samuel K Wood, MD
• Walter A Wood, ILLINOIS LICENSED HE
• Brite Woodruff, PT
• Brenna Woods
• Ian Woodward
• Nicole Woolley, DNP
• Samantha Woolman, CPM, LM
• Norman D. Workman, D.D.S.
• World of Wellness
• Christine M. Worth, PT

• Public Health Dentistry in Cedar Rapids, IA
• Providers in Cedar Rapids, IA by specialty
• Public Health Dentistry in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2024; 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.