Healthcare Provider Details

I. General information

NPI: 1689500860
Provider Name (Legal Business Name): KIMBERLY DAO DDS
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8951 KNOTT AVE STE L
BUENA PARK CA
90620-4108
US

IV. Provider business mailing address

18 ROCKINGHAM DR
NEWPORT BEACH CA
92660-4218
US

V. Phone/Fax

Practice location:
  • Phone: 714-826-4181
  • Fax:
Mailing address:
  • Phone: 559-906-7964
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number113132
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: