Woo Jong Ko, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DD5099 Issued in NM

Practice address

1998 N Motel Blvd
Las Cruces, NM 88007-4100

Phone

(575) 541-5941

Fax

(575) 541-5048

NPI assigned

Jan 19, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NM

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563494400000",
    "number": "1669452108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 370",
            "city": "HATCH",
            "state": "NM",
            "postal_code": "879370370",
            "telephone_number": "575-267-3280",
            "fax_number": "575-267-1747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1998 N MOTEL BLVD",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880074100",
            "telephone_number": "575-541-5941",
            "fax_number": "575-541-5048"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12150 New York Ranch Rd",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "CA",
            "postal_code": "956429407",
            "country_code": "US",
            "telephone_number": "209-257-2460",
            "fax_number": "209-257-2464",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KO",
        "first_name": "WOO",
        "middle_name": "JONG",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-19",
        "last_updated": "2019-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NM",
            "license": "DD5099",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "54058",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Knodle
• Yolanda Knodle
• Kenneth Eugene Knott, DDS
• Kimberly Marie Knox, LMSW
• Alison Ko
• Karl P. Koerper, MD
• Monthe Nicholas Kofos
• Josiah Paul Kohler, FNP
• Caryn Kohlrust, ATC, LAT
• Balaram Kolasani

• General Practice Dentistry in Las Cruces, NM
• Providers in Las Cruces, NM by specialty
• General Practice Dentistry in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.