Individual provider Active NPI

Carol Beth Wooddell, DDS

  • Pediatric Dentistry
  • Burke, VA
National Provider Identifier
1760500086
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
0401006991 Issued in VA
Practice address
9295 Old Keene Mill Rd
Burke, VA 22015-4202
Phone
(703) 440-9701
Fax
(703) 440-9703
NPI assigned
Mar 26, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 0401006991 VA Primary

Addresses

Primary practice location

9295 Old Keene Mill Rd
Burke, VA 22015-4202

Mailing address

9295 Old Keene Mill Rd
Burke, VA 22015-4202
Phone (703) 440-9701

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0401006991VAMDPediatric Dentist

NPI Registry JSON

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1760500086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9295 OLD KEENE MILL RD",
            "city": "BURKE",
            "state": "VA",
            "postal_code": "220154202",
            "telephone_number": "703-440-9701",
            "fax_number": "703-440-9703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9295 OLD KEENE MILL RD",
            "city": "BURKE",
            "state": "VA",
            "postal_code": "220154202",
            "telephone_number": "703-440-9701",
            "fax_number": "703-440-9703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODDELL",
        "first_name": "CAROL",
        "middle_name": "BETH",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "VA",
            "license": "0401006991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burke, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.