Healthcare Provider Details

I. General information

NPI: 1902759814
Provider Name (Legal Business Name): WOODFORD DENTISTRY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/19/2026
Last Update Date: 02/19/2026
Certification Date: 02/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16716 CHILLICOTHE RD STE 700
CHAGRIN FALLS OH
44023-6504
US

IV. Provider business mailing address

16716 CHILLICOTHE RD STE 700
CHAGRIN FALLS OH
44023-6504
US

V. Phone/Fax

Practice location:
  • Phone: 440-708-0900
  • Fax: 440-708-0904
Mailing address:
  • Phone: 440-708-0900
  • Fax: 440-708-0904

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: BRIDGET WOODFORD
Title or Position: OWNER
Credential: DDS
Phone: 216-849-7517