Healthcare Provider Details

I. General information

NPI: 1003730391
Provider Name (Legal Business Name): DAO VO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2026
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12800 HEACOCK ST STE A1
MORENO VALLEY CA
92553-2868
US

IV. Provider business mailing address

1294 VOLTAIRE DR
RIVERSIDE CA
92506-5397
US

V. Phone/Fax

Practice location:
  • Phone: 951-239-3654
  • Fax:
Mailing address:
  • Phone: 951-901-0717
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number113582
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: