Stephen M. Woodall, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

45794 Issued in CA

Legal business name

STEPHEN M. WOODALL, DDS

Practice address

3180 Willow LN
Suite 208
Thousand Oaks, CA 91361-4941

Phone

(805) 496-9775

Fax

(805) 373-7084

NPI assigned

Feb 16, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Steve Woodall, DDS

Title

Owner

Phone

(805) 496-9775

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1399248000000",
    "number": "1871637355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3180 WILLOW LN",
            "address_2": "SUITE 208",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913614941",
            "telephone_number": "805-496-9775",
            "fax_number": "805-373-7084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3180 WILLOW LN",
            "address_2": "SUITE 208",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913614941",
            "telephone_number": "805-496-9775",
            "fax_number": "805-373-7084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEPHEN M. WOODALL, DDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-16",
        "last_updated": "2014-05-05",
        "status": "A",
        "authorized_official_last_name": "WOODALL",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "805-496-9775",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "45794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2014; 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.