John Samuel Woo, D.D.S., M.S.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

39579 Issued in CA

Practice address

1476 Professional Dr
Suite 506
Petaluma, CA 94954-1500

Phone

(707) 762-0211

Fax

(707) 762-5149

NPI assigned

Mar 5, 2007

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

Credentials

Master of Science

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• DRS. Woo and Deberardinis

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Petaluma, CA
  • NPI 1568638633

  Orthodontics and Dentofacial Orthopedics

  NPD (past) Authorized official

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487783775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1598 CUNNINGHAM RD",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954725535",
            "telephone_number": "707-823-9078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1476 PROFESSIONAL DR",
            "address_2": "SUITE 506",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949541500",
            "telephone_number": "707-762-0211",
            "fax_number": "707-762-5149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOO",
        "first_name": "JOHN",
        "middle_name": "SAMUEL",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "39579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Audrey Wolff
• Gordon Miles Wong, OD
• Kristi Rose Lim Wong
• Melissa Wong, NP
• Amanda C. Wongsonegoro, CMT
• Emily Anne Wood, PA
• Stephen K Woolmer, M.F.T.
• America Worden, MFT
• Meliah Etelbina World Turner
• Wound MD PC

• All providers in Petaluma, CA
• Orthodontics and Dentofacial Orthopedics Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.