Andrea Davis Wood, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN011029 Issued in GA

Practice address

1536 Eisenhower Pkwy
Macon, GA 31206-3130

Phone

(478) 781-4333

Fax

(478) 781-4331

NPI assigned

Aug 31, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in GA

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606348800000",
    "number": "1285745505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1316 BOAT ROCK RD SW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303317316",
            "telephone_number": "404-310-6548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1536 EISENHOWER PKWY",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312063130",
            "telephone_number": "478-781-4333",
            "fax_number": "478-781-4331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOD",
        "first_name": "ANDREA",
        "middle_name": "DAVIS",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2020-11-26",
        "certification_date": "2020-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN011029",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000471875",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "1429244",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVESIS",
            "identifier": "100759",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAQUEST",
            "identifier": "9180606",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Women'S Imaging Specialists - Macon, LLC
• Women'S Specialty Care PC
• Womens Health Institute of Stockbridge LLC
• Wonderlandd Intl Company, LLC
• Amy Wood, NP
• Crystal Sadler Wood, R.PH.
• Hayden Wood, OTR
• Jennifer Gwen Wood, PA-C
• John L Wood, M.D.
• Jordan Lee Wood, FNP

• General Practice Dentistry in Macon, GA
• Providers in Macon, GA by specialty
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.