Active NPI
Brooke M Wood, DDS
- Pediatric Dentistry
- Baton Rouge, LA
National Provider Identifier
1972708238
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 5846
- Practice address
- 9804 Bluebonnet Blvd
Ste a
Baton Rouge, LA 70810-6442 - Phone
- (225) 796-1969
- NPI assigned
- Jun 18, 2007
- Last updated
- Dec 23, 2011
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 5846 | LA | Primary |
Addresses
Primary practice location
9804 Bluebonnet Blvd
Ste a
Baton Rouge, LA 70810-6442
Mailing address
9804 Bluebonnet Blvd
Ste a
Baton Rouge, LA 70810-6442
Phone (225) 796-1969
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1858463 | Medicaid | LA |
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 |
|---|---|---|---|
| 5846 | LA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1182124800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1324598400000",
"number": "1972708238",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9804 BLUEBONNET BLVD",
"address_2": "STE A",
"city": "BATON ROUGE",
"state": "LA",
"postal_code": "708106442",
"telephone_number": "225-796-1969"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9804 BLUEBONNET BLVD",
"address_2": "STE A",
"city": "BATON ROUGE",
"state": "LA",
"postal_code": "708106442",
"telephone_number": "225-796-1969"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOOD",
"first_name": "BROOKE",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-06-18",
"last_updated": "2011-12-23",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "LA",
"license": "5846",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1858463",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Baton Rouge, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.