Brian M. Woo, D.D.S., M.D., Inc.

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

License

A107428 Issued in CA

Legal business name

BRIAN M. WOO, D.D.S., M.D., INC.

Practice address

290 North Wayte Lane
Fresno, CA 93701-1324

Phone

(559) 459-5120

NPI assigned

May 11, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Brian Michael Woo, D.D.S., M.D.

Title

President/Owner

Phone

(559) 459-5120

Specialties & licenses 6

Addresses

Other identifiers 3

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

{
    "created_epoch": "1242000000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1982838579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "290 NORTH WAYTE LANE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937011324",
            "telephone_number": "559-459-5120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "290 NORTH WAYTE LANE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937011324",
            "telephone_number": "559-459-5120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIAN M. WOO, D.D.S., M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-11",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "WOO",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "559-459-5120",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S., M.D."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "50017",
            "primary": false
        },
        {
            "code": "1223P0106X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "CA",
            "license": "50017",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "50017",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "CA",
            "license": "A107428",
            "primary": true
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "CA",
            "license": "A107428",
            "primary": false
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Trauma Surgery",
            "state": "CA",
            "license": "A107428",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GENERAL ANESTHESIA LICENSE",
            "identifier": "GA 1484",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "A107428",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL LICENSE",
            "identifier": "50017",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bernardo Bretado
• David Alan Brethouwer, D.O.
• Rebekah Elizabeth Wilson Brevard
• Philip Clarke Brewer, MS, LMFT
• Rhonda Brewer
• David Santos Briceno I
• Jorge Briceno
• Sinda Briceno
• Bridge Project Fresno
• Bridgit M. Khater, DDS and Roger a. Khater, DDS, Inc.

• Oral & Maxillofacial Surgery (D.M.D.) in Fresno, CA
• Providers in Fresno, CA by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.