Healthcare Provider Details

I. General information

NPI: 1598802050
Provider Name (Legal Business Name): LING CAO DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/31/2007
Last Update Date: 09/20/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

43713 BOSCELL RD
FREMONT CA
94538-5125
US

IV. Provider business mailing address

43206 BANDA TER
FREMONT CA
94539-5635
US

V. Phone/Fax

Practice location:
  • Phone: 510-770-8688
  • Fax: 510-770-8588
Mailing address:
  • Phone: 510-449-1831
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number53975
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: