Active NPI
Ty Louis Wooden, D.D.S.
- Dentist
- Reidsville, NC
National Provider Identifier
1326329509
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 9210
- Practice address
- 1106 S Park Dr
Reidsville, NC 27320-5514 - Phone
- (336) 349-9269
- Fax
- (336) 634-1798
- NPI assigned
- Sep 1, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 9210 | NC | Primary |
Addresses
Primary practice location
1106 S Park Dr
Reidsville, NC 27320-5514
Mailing address
1106 S Park Dr
Reidsville, NC 27320-5514
Phone (336) 349-9269
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9210 | NC | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jay J. Coyle DDS & Associates PA | Dentist | Past | Accepting new patients |
| William Summerville DDS PLLC | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Dentist
- Charlotte, NC
- NPI 1245452333
-
- General Practice Dentistry
- Charlotte, NC
- NPI 1386681625
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1314835200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1782864000000",
"number": "1326329509",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1106 S PARK DR",
"city": "REIDSVILLE",
"state": "NC",
"postal_code": "273205514",
"telephone_number": "336-349-9269",
"fax_number": "336-634-1798"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1106 S PARK DR",
"city": "REIDSVILLE",
"state": "NC",
"postal_code": "273205514",
"telephone_number": "336-349-9269",
"fax_number": "336-634-1798"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOODEN",
"first_name": "TY",
"middle_name": "LOUIS",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-09-01",
"last_updated": "2026-07-01",
"certification_date": "2026-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NC",
"license": "9210",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Reidsville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.