NPIMap

Organization Active NPI

DRS. Woo and Deberardinis

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Petaluma, CA
National Provider Identifier
1568638633
Registry record updated May 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
39579 Issued in CA
Legal business name
DRS. WOO AND DEBERARDINIS
Practice address
1476 Professional Dr
Suite 506
Petaluma, CA 94954-1500
Phone
(707) 762-0211
Fax
(707) 762-5149
NPI assigned
May 7, 2008
Last updated
May 7, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 7, 2008

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

Authorized official

Name
John Samuel Woo, D.D.S.NPI 1487783775
Title
Owner
Phone
(707) 762-0211

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 39579 CA Primary

Addresses

Primary practice location

1476 Professional Dr
Suite 506
Petaluma, CA 94954-1500

Mailing address

1476 Professional Dr
Suite 506
Petaluma, CA 94954-1500
Phone (707) 762-0211

National Provider Directory

National Provider Directory

Locations

1476 Professional Dr
Ste 506
Petaluma, CA 94954
Phone (707) 762-0211

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1210118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210118400000",
    "number": "1568638633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "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"
        },
        {
            "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": {
        "organization_name": "DRS. WOO AND DEBERARDINIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-07",
        "last_updated": "2008-05-07",
        "status": "A",
        "authorized_official_last_name": "WOO",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "SAMUEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "707-762-0211",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "39579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Petaluma, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2008; 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.