Individual provider Active NPI

Scott C Woodbury, DMD MD

  • Oral and Maxillofacial Surgery (Dentist)
  • Saginaw, MI
National Provider Identifier
1639244940
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
2901017356 Issued in MI
Practice address
4350 Fashion Square Boulevard
Saginaw, MI 48603-1249
Phone
(989) 799-7128
Fax
(989) 799-3895
NPI assigned
Nov 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 2901017356 MI Primary
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X 2901017356 MI

Addresses

Primary practice location

4350 Fashion Square Boulevard
Saginaw, MI 48603-1249

Mailing address

4350 Fashion Square Boulevard
Saginaw, MI 48603-1249
Phone (989) 799-7128

Other identifiers 1

IdentifierTypeStateIssuer
OG361000OtherMIBLUE CROSS BLUE SHIELD

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050322000140 MI Practitioner - Maxillofacial SurgeryPractitioner - Oral Surgery 6103871462 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Maxillofacial SurgeryAlso: Oral Surgery
Education
University of Pittsburgh School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hennig Woodbury and Howard PCGroup PAC ID 3577518828, 2 clinicians

Practice addresses (Care Compare)

4350 Fashion Square Blvd
Saginaw, MI 48603-1249
Phone (989) 799-7128

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Hennig Woodbury & Howard PC Oral and Maxillofacial Surgery CurrentSince Jul 6, 1998 Accepting new patients

Locations

4 Columbus Ave
Ste 150
Bay City, MI 48708
Phone (989) 893-3090

4350 Fashion Square Blvd
Saginaw, MI 48603
Phone (989) 799-7128

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1639244940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4350 FASHION SQUARE BOULEVARD",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486031249",
            "telephone_number": "989-799-7128",
            "fax_number": "989-799-3895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4350 FASHION SQUARE BOULEVARD",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486031249",
            "telephone_number": "989-799-7128",
            "fax_number": "989-799-3895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODBURY",
        "first_name": "SCOTT",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "DMD MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-21",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MI",
            "license": "2901017356",
            "primary": true
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "MI",
            "license": "2901017356",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "OG361000",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saginaw, MI

Sources for this page

Verify at the official NPI Registry.