Organization Active NPI

Donna J. Woo, D.D.S. Inc.

  • Dental Clinic/Center
  • Anaheim, CA
National Provider Identifier
1811194152
Registry record updated Mar 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
DONNA J. WOO, D.D.S. INC.
Practice address
420 S State College Blvd
Anaheim, CA 92806-4119
Phone
(909) 973-4086
NPI assigned
Jun 29, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2021

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

Authorized official

Name
Dr. Donna Jeanette Woo, D.D.S.NPI 1942229273
Title
Dentist Business Owner
Phone
(714) 772-0770

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
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

420 S State College Blvd
Anaheim, CA 92806-4119

Mailing address

420 S State College Blvd
Anaheim, CA 92806-4119
Phone (714) 772-0770

Other identifiers 2

IdentifierTypeStateIssuer
G92495-01OtherCADENTI-CAL
764870OtherCAUNITED CONCORDIA PROV. #

Other names 1

  • Westport Dental Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210528001261 CA Part B Supplier - Clinic/Group Practice 4183023831 Receives reassigned benefits from 3 practitioners
Practice locations: Anaheim, CA

National Provider Directory

National Provider Directory

Locations

20779 Bear Valley Rd
#7B
Apple Valley, CA 92308

17612 Beach Blvd
Ste 7A
Huntington Beach, CA 92647

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1183075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615420800000",
    "number": "1811194152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 S STATE COLLEGE BLVD",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928064119",
            "telephone_number": "714-772-0770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 S STATE COLLEGE BLVD",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928064119",
            "telephone_number": "909-973-4086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DONNA J. WOO, D.D.S. INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-29",
        "last_updated": "2021-03-11",
        "certification_date": "2021-03-11",
        "status": "A",
        "authorized_official_last_name": "WOO",
        "authorized_official_first_name": "DONNA",
        "authorized_official_middle_name": "JEANETTE",
        "authorized_official_title_or_position": "DENTIST BUSINESS OWNER",
        "authorized_official_telephone_number": "714-772-0770",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTI-CAL",
            "identifier": "G92495-01",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA PROV. #",
            "identifier": "764870",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Westport Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Anaheim, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.