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Individual
JON MICHAEL WOODRUFF
Active
Individual
JON MICHAEL WOODRUFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
6814
KS
122300000X
Dentist
DS044372
PA
1223G0001X
General Practice Dentistry
Primary
DS044372
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000781486
UNITED CONCORDIA OF KS
—
01
—
017363
BLUE CROSS BLUE SHIELD
KS
05
—
100225410-B
—
KS
05
—
1042785600001
—
PA
Enumeration date
08/25/2005
Last updated
01/31/2025
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