DR. BRIAN MICHAEL WOO (NPI# 1558579144) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558579144 |
| Entity Type | Individual |
| Full Name | DR. BRIAN MICHAEL WOO |
| Credential | DDS, MD |
| Practice Address |
290 North Wayte Lane Fresno CA 93701-1324 |
| Practice Telephone | 5594595120 |
| Mailing Telephone | 5594595120 |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2010-04-15 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 122300000X | Dentist | 50017 | CA | Dental Providers |
| N | 1223P0106X |
Dentist Specialization: Oral and Maxillofacial Pathology |
50017 | CA | Dental Providers |
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
50017 | CA | Dental Providers |
| N | 204E00000X | Oral & Maxillofacial Surgery | A107428 | CA | Allopathic & Osteopathic Physicians |
| N | 2086S0122X |
Surgery Specialization: Plastic and Reconstructive Surgery |
A107428 | CA | Allopathic & Osteopathic Physicians |
| N | 2086S0127X |
Surgery Specialization: Trauma Surgery |
A107428 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | DEA NUMBER | BW8380381 | 01 |
| CA | MEDICAL LICENSE | A107428 | 01 |
| CA | GENERAL ANESTHESIA LICENSE | GA 1484 | 01 |
| CA | DENTAL LICENSE | 50017 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346860889 | Brian Woo | Pharmacy Technician | 10889 Wellworth Ave, Los Angeles, CA 90024-4918 | 2020-04-24 |
| 1588977524 | Brian Douglas Woo | Emergency Medicine | 1141 Rose Ave, Selma, CA 93662-3241 | 2010-07-20 |
| Street Address |
290 NORTH WAYTE LANE |
| City | FRESNO |
| State | CA |
| Zip Code | 93701-1324 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982838579 | Brian M. Woo, D.d.s., M.d., Inc. | Dentist | 290 North Wayte Lane, Fresno, CA 93701-1324 | 2009-05-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134740244 | Tamara Sue Stanic | Registered Nurse | 215 N. Fresno Street, Suite 370, Fresno, CA 93701 | 2020-04-29 |
| 1144849829 | Katelyn Nicole Van Leir | Student in an Organized Health Care Education/Training Program | Surabian Dental Care Center - Suite 2500, 290 N. Wayte Lane, Fresno, CA 93701 | 2020-04-13 |
| 1003445693 | Michelle Edwardson | Registered Nurse | 215 North Fresno Street, Suite 370, Fresno, CA 93701 | 2020-04-06 |
| 1184253924 | Patricia Calderon | Registered Nurse | 215 N. Fresno Street, Suite 230, Fresno, CA 93701 | 2020-04-03 |
| 1922637032 | Leticia Lopez | Registered Nurse | 215 N. Fresno Street, Suite 230, Fresno, CA 93701 | 2020-04-02 |
| 1275026585 | Yesenia Gonzalez | Nurse Practitioner | 311 Abby Street, Fresno, CA 93701 | 2018-06-11 |
| 1710474606 | Amanda Juarez | Dietitian, Registered | 215 N Fresno, Suite 370, Fresno, CA 93701 | 2018-04-17 |
| 1235650391 | Plastic Surgery Partners of Fresno Inc | Plastic Surgery | 215 N Fresno St, Ste 490, Fresno, CA 93701 | 2017-06-29 |
| 1205369790 | Amy Alagh | Student in an Organized Health Care Education/Training Program | 155 N Fresno Street, Fresno, CA 93701 | 2017-04-11 |
| 1922462159 | Henry Matthew Dunn | Student in an Organized Health Care Education/Training Program | Ucsf Fresno, 155 N. Fresno St., Department of Orthopaedic Surgery, Fresno, CA 93701 | 2016-04-13 |
| Find all providers in zip 93701 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073173860 | Omfs Care Center Partners | Dentist | 215 N Fresno St Ste 490, Fresno, CA 93701-0000 | 2019-06-14 |
| 1306212428 | Robin Lynn Reisz | Dentist | 1105 E Spruce Ave Ste 204, Fresno, CA 93720-3313 | 2015-08-12 |
| 1396155875 | Phillip Austin Harrison | Dentist | 1195 W San Ramon Ave, Fresno, CA 93711-3152 | 2014-05-05 |
| 1417390253 | Brian K Huh | Dentist | 1903 E Fir Ave Ste 101, Fresno, CA 93720-3862 | 2013-04-11 |
| 1164688396 | Shabaz Sandhu | Dentist | 498 W Bluff Ave, Fresno, CA 93711-6928 | 2008-08-07 |
| 1962699777 | Scott J. Fimbres, D.d.s., Inc. | Dentist | 7585 N Colonial Ave Ste 105, Fresno, CA 93711 | 2007-09-26 |
| 1952528671 | Jason Sorensen D.d.s. A Professional Corporation | Dentist | 1480 W Herndon Ave, Fresno, CA 93711-0552 | 2007-04-20 |
| 1508938523 | Center for Corrective Jaw & Facial Surgery .... | Dentist | 7055 N Fresno St #202, Fresno, CA 93720 | 2006-11-14 |
| 1831282755 | David Russell Adams | Dentist | 1111 E Herndon Ave Ste 119, Fresno, CA 93720-3100 | 2006-10-02 |
| 1144257619 | Gerald Wayne Alexander | Dentist | 7585 N Colonial Ave, Ste 105, Fresno, CA 93711-5889 | 2006-06-28 |
| Find all providers in FRESNO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.