Healthcare Provider Details

I. General information

NPI: 1942492442
Provider Name (Legal Business Name): DOROTHY CHAO, DDS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2007
Last Update Date: 02/27/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7757 KATELLA AVE SUTIE D
STANTON CA
90680-4901
US

IV. Provider business mailing address

7757 KATELLA AVE SUTIE D
STANTON CA
90680-4901
US

V. Phone/Fax

Practice location:
  • Phone: 714-209-7702
  • Fax: 714-209-7658
Mailing address:
  • Phone: 714-209-7702
  • Fax: 714-209-7658

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number44847
License Number StateCA

VIII. Authorized Official

Name: DOROTHY WENYI CHAO
Title or Position: OWNER
Credential: DDS
Phone: 714-209-7702