Individual provider Active NPI

David C Woodburn, DDS

  • General Practice Dentistry
  • Amarillo, TX
National Provider Identifier
1366447393
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
9846 Issued in TX
Practice address
3609 S Georgia St
Amarillo, TX 79109-4847
Phone
(806) 358-7471
Fax
(806) 358-1883
NPI assigned
Jun 16, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 9846 TX Primary

Addresses

Primary practice location

3609 S Georgia St
Amarillo, TX 79109-4847

Mailing address

3609 S Georgia St
Amarillo, TX 79109-4847
Phone (806) 358-7471

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20140822001699 TX Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 1850519448

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9846TXMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1366447393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3609 S GEORGIA ST",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791094847",
            "telephone_number": "806-358-7471",
            "fax_number": "806-358-1883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3609 S GEORGIA ST",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791094847",
            "telephone_number": "806-358-7471",
            "fax_number": "806-358-1883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODBURN",
        "first_name": "DAVID",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-16",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "9846",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amarillo, TX

Sources for this page

Verify at the official NPI Registry.