Healthcare Provider Details

I. General information

NPI: 1295937811
Provider Name (Legal Business Name): HOANGSON DAO DDS & MICHAEL DAO DMD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2007
Last Update Date: 08/03/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 E COMPTON BLVD
COMPTON CA
90220-2410
US

IV. Provider business mailing address

125 E COMPTON BLVD
COMPTON CA
90220-2410
US

V. Phone/Fax

Practice location:
  • Phone: 310-856-0687
  • Fax: 310-856-0689
Mailing address:
  • Phone: 310-856-0687
  • Fax: 310-856-0689

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberCA43931
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberCA46776
License Number StateCA

VIII. Authorized Official

Name: DR. MICHAEL TUAN DAO
Title or Position: PRIMARY DENTIST
Credential: DMD
Phone: 714-785-1352