Individual provider Active NPI

Amira Woodruff, D.D.S.

  • Dentist
  • West Bloomfield, MI
National Provider Identifier
1356634075
Registry record updated Jan 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901020391 Issued in MI
Practice address
6900 Orchard Lake Rd
Suite 211
West Bloomfield, MI 48322-3405
Phone
(248) 973-8788
NPI assigned
May 27, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2901020391 MI Primary

Addresses

Primary practice location

6900 Orchard Lake Rd
Suite 211
West Bloomfield, MI 48322-3405

Mailing address

6900 Orchard Lake Rd
Suite 211
West Bloomfield, MI 48322-3405
Phone (248) 973-8788

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20170126001831 MI Order and Referring Only - DentistPractitioner - Dentist 0446532493

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2901020391MIMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Caring Smiles Family Dentistry, PC Past Accepting new patients

Organizations & group practices 1

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": "1306454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485302400000",
    "number": "1356634075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6900 ORCHARD LAKE RD",
            "address_2": "SUITE 211",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483223405",
            "telephone_number": "248-973-8788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6900 ORCHARD LAKE RD",
            "address_2": "SUITE 211",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483223405",
            "telephone_number": "248-973-8788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODRUFF",
        "first_name": "AMIRA",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-27",
        "last_updated": "2017-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901020391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Bloomfield, MI

Sources for this page

Verify at the official NPI Registry.