Organization Active NPI

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

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Fresno, CA
National Provider Identifier
1982838579
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
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
Last updated
Mar 7, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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.NPI 1558579144
Title
President/Owner
Phone
(559) 459-5120

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 50017 CA
Oral and Maxillofacial Pathology DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0106X 50017 CA
Oral and Maxillofacial Surgery (Dentist)Group: 193200000X MULTI-SPECIALTY GROUP 1223S0112X 50017 CA
Oral & Maxillofacial Surgery (D.M.D.)Group: 193200000X MULTI-SPECIALTY GROUP 204E00000X A107428 CA Primary
Plastic and Reconstructive Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086S0122X A107428 CA
Trauma Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086S0127X A107428 CA

Addresses

Primary practice location

290 North Wayte Lane
Fresno, CA 93701-1324

Mailing address

290 North Wayte Lane
Fresno, CA 93701-1324
Phone (559) 459-5120

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

  • 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.