Provider Demographics
NPI:1669673877
Name:WOODFILL, JAMIE B (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMIE
Middle Name:B
Last Name:WOODFILL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5905 W BELL RD
Mailing Address - Street 2:STE 6
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-3790
Mailing Address - Country:US
Mailing Address - Phone:602-547-9566
Mailing Address - Fax:602-547-1856
Practice Address - Street 1:5905 W BELL RD
Practice Address - Street 2:STE 6
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-3790
Practice Address - Country:US
Practice Address - Phone:602-547-9566
Practice Address - Fax:602-547-1856
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2019-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD66481223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice