Ian Woo, MS, DDS, MD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

50018 Issued in CA

Practice address

763 Cereza Dr
Monterey Park, CA 91754-2317

Phone

(323) 369-1066

NPI assigned

Jul 2, 2008

Last updated

Jun 17, 2009By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Apr 25, 2018 through Apr 25, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine, 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dr. Ian Woo Ms MD DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Monterey Park, CA
  • NPI 1710393418
  NPD (past) Authorized official

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

{
    "created_epoch": "1214956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245196800000",
    "number": "1679736425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "763 CEREZA DR",
            "city": "MONTEREY PARK",
            "state": "CA",
            "postal_code": "917542317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "763 CEREZA DR",
            "city": "MONTEREY PARK",
            "state": "CA",
            "postal_code": "917542317",
            "telephone_number": "323-369-1066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOO",
        "first_name": "IAN",
        "name_prefix": "Dr.",
        "credential": "MS, DDS, MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-02",
        "last_updated": "2009-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "50018",
            "primary": true
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "CA",
            "license": "A97980",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Wong, PHARMD
• Pina K Wong, MD
• Sunny Wing CHI Wong, D.O.
• Tin-Cheu Wong, M.D.
• Denise Woo
• Lillian Woo, PA-C
• Young Uk Woo, L.AC
• Hannah M Wright, PA-C
• Kaliya Wright
• Eric Wu

• Oral and Maxillofacial Surgery (Dentist) in Monterey Park, CA
• Providers in Monterey Park, CA by specialty
• Oral and Maxillofacial Surgery (Dentist) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2009; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.