Charles Conley Wood, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

25655 Issued in CA

Practice address

620 Montana Ave
Santa Monica, CA 90403-1402

Phone

(310) 451-5563

Fax

(310) 451-5218

NPI assigned

May 24, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198022400000",
    "number": "1295738169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 MONTANA AVE",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904031402",
            "telephone_number": "310-451-5563",
            "fax_number": "310-451-5218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 MONTANA AVE",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904031402",
            "telephone_number": "310-451-5563",
            "fax_number": "310-451-5218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOD",
        "first_name": "CHARLES",
        "middle_name": "CONLEY",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-24",
        "last_updated": "2007-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "25655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Wong
• Steven Gene Wei Wong, MD
• Timothy Kenji Wong, PH.D.
• William Samuel Wong, DDS
• Craighton Brian Woo, D.D.S., M.S.
• Connie A Wood, PT
• Cristina Wood, MFT
• Cynthia L. Wood, RPT
• James Wood, M.F.T
• Jennifer Lynn Wood, D.D.S.

• General Practice Dentistry in Santa Monica, CA
• Providers in Santa Monica, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2007; 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.