NPIMap

Organization Active NPI

Valerie Woodruff DDS PC

  • General Practice Dentistry
  • Mahomet, IL
National Provider Identifier
1629227392
Registry record updated Sep 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
060.009802 Issued in IL
Legal business name
VALERIE WOODRUFF DDS PC
Practice address
200 N Eastwood Drive
Mahomet, IL 61853
Phone
(217) 586-5667
Fax
(217) 586-5781
NPI assigned
Sep 17, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2008

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

Authorized official

Name
Dr. Valerie Woodruff, DDS PCNPI 1609918895
Title
President
Phone
(217) 586-5667

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 060.009802 IL Primary

Addresses

Primary practice location

200 N Eastwood Drive
Mahomet, IL 61853

Mailing address

PO Box 709
200 N Eastwood Drive
Mahomet, IL 61853
Phone (217) 586-5667

National Provider Directory

National Provider Directory

Locations

200 Eastwood Dr
Mahomet, IL 61853
Phone (217) 586-5667

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1221609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221609600000",
    "number": "1629227392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 709",
            "address_2": "200 N EASTWOOD DRIVE",
            "city": "MAHOMET",
            "state": "IL",
            "postal_code": "61853",
            "telephone_number": "217-586-5667",
            "fax_number": "217-586-5781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 N EASTWOOD DRIVE",
            "city": "MAHOMET",
            "state": "IL",
            "postal_code": "61853",
            "telephone_number": "217-586-5667",
            "fax_number": "217-586-5781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALERIE WOODRUFF DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-17",
        "last_updated": "2008-09-17",
        "status": "A",
        "authorized_official_last_name": "WOODRUFF",
        "authorized_official_first_name": "VALERIE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "217-586-5667",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS PC"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "060.009802",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mahomet, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2008; 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.