Individual provider Active NPI

Ernest Stanley Woodard, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Little Rock, AR
National Provider Identifier
1407869399
Registry record updated May 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
3423 Issued in AR
Practice address
11300 Cantrell Rd Ste 303
Little Rock, AR 72212-1844
Phone
(501) 228-5700
NPI assigned
Aug 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 3423 AR Primary

Addresses

Primary practice location

11300 Cantrell Rd Ste 303
Little Rock, AR 72212-1844

Mailing address

11300 Cantrell Rd Ste 303
Little Rock, AR 72212-1844
Phone (501) 228-5700

Other identifiers 1

IdentifierTypeStateIssuer
150289679MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20040216000331 AR Practitioner - Oral SurgeryPractitioner - Maxillofacial Surgery 0042105561 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Oral Surgery
Education
Other, 2003
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

11300 Cantrell Rd
Suite 303
Little Rock, AR 72212-1844
Phone (501) 228-5700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304380800000",
    "number": "1407869399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11300 CANTRELL RD STE 303",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722121844",
            "telephone_number": "501-228-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11300 CANTRELL RD STE 303",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722121844",
            "telephone_number": "501-228-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODARD",
        "first_name": "ERNEST",
        "middle_name": "STANLEY",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-14",
        "last_updated": "2011-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "AR",
            "license": "3423",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "150289679",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.