Active NPI
Kenneth K Woo, DDS, MAGD
- General Practice Dentistry
- Seekonk, MA
National Provider Identifier
1942460324
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 16623
- Practice address
- 1563 Fall River Ave
Seekonk, MA 02771-3736 - Phone
- (508) 336-7755
- Fax
- (508) 336-9940
- NPI assigned
- Jun 10, 2008
- Last updated
- Jun 10, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 16623 | MA | Primary |
Addresses
Primary practice location
1563 Fall River Ave
Seekonk, MA 02771-3736
Mailing address
1563 Fall River Ave
Seekonk, MA 02771-3736
Phone (508) 336-7755
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8503-4 | Other | RI | BLUE CROSS BLUE SHIELD |
| X11529 | Other | MA | BLUE CROSS BLUE SHIELD |
| 190633 | Other | UNITED CONCORDIA | |
| 16623 | Other | RI | DELTA DENTAL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16623 | MA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kenneth K Woo PC | General Practice | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1213056000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1213056000000",
"number": "1942460324",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1563 FALL RIVER AVE",
"city": "SEEKONK",
"state": "MA",
"postal_code": "027713736",
"telephone_number": "508-336-7755",
"fax_number": "508-336-9940"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1563 FALL RIVER AVE",
"city": "SEEKONK",
"state": "MA",
"postal_code": "027713736",
"telephone_number": "508-336-7755",
"fax_number": "508-336-9940"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOO",
"first_name": "KENNETH",
"middle_name": "K",
"name_prefix": "Dr.",
"credential": "DDS, MAGD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-06-10",
"last_updated": "2008-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MA",
"license": "16623",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "8503-4",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "X11529",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED CONCORDIA",
"identifier": "190633",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DELTA DENTAL",
"identifier": "16623",
"state": "RI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Seekonk, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 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.