Wood Dental Group, P.a.

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

WOOD DENTAL GROUP, P.A.

Practice address

715 Calvin Avery
West Memphis, AR 72301

Phone

(870) 735-3601

Fax

(870) 732-9535

NPI assigned

Sep 15, 2006

Organization subpart

No

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

Authorized official

Name

Charles S Wood Jr., D.D.S.

Title

Owner

Phone

(870) 735-3601

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Wood & Cook Dental Group Former legal business name

Locations

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601510400000",
    "number": "1508962937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 CALVIN AVERY DR",
            "city": "WEST MEMPHIS",
            "state": "AR",
            "postal_code": "72301",
            "telephone_number": "870-735-3601",
            "fax_number": "870-732-9535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 CALVIN AVERY",
            "city": "WEST MEMPHIS",
            "state": "AR",
            "postal_code": "72301",
            "telephone_number": "870-735-3601",
            "fax_number": "870-732-9535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOOD DENTAL GROUP, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-15",
        "last_updated": "2020-10-01",
        "certification_date": "2020-10-01",
        "status": "A",
        "authorized_official_last_name": "WOOD",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "870-735-3601",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101993608",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wood & Cook Dental Group",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Raquel Wilson, PMHNP-BC
• Taylor Danielle Wilson
• Jasmine C Winda
• Cynthia Roy Winters, RPH
• WM Crittenden Operations LLC
• Charles Senter Wood Jr., DDS
• Woodridge Northeast, LLC
• Woodridge of West Memphis, LLC
• Beatrice M Woods
• Edward Woods

• Dentist in West Memphis, AR
• Providers in West Memphis, AR by specialty
• Dentist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.