MEDICARE: DR. AINSLIE JACOB WOODWARD JR. DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	2901603106	MI

General Provider Information

NPI Number	:	1427987494
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AINSLIE JACOB WOODWARD JR. DDS

Provider Business Mailing Address
First Line	:	3670 S JOHN HIX RD APT 21
Second Line	:
City	:	WAYNE
State	:	MI
Zip	:	48184-2834
Country	:	US
Telephone Number	:	313-920-7809
Fax Number	:

Provider Business Practice Location Address
First Line	:	11200 E MCNICHOLS RD
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48234-3929
Country	:	US
Telephone Number	:	313-521-6400
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/15/2026
Last Update Date	:	05/15/2026

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