Healthcare Provider Details

I. General information

NPI: 1487484317
Provider Name (Legal Business Name): YUQI CAO DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2024
Last Update Date: 08/05/2024
Certification Date: 08/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4190 TRUXEL RD
SACRAMENTO CA
95834-3757
US

IV. Provider business mailing address

3761 E COMMERCE WAY APT 2405
SACRAMENTO CA
95834-4065
US

V. Phone/Fax

Practice location:
  • Phone: 916-928-9999
  • Fax:
Mailing address:
  • Phone: 315-731-7975
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number110458
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: