Healthcare Provider Details

I. General information

NPI: 1841292166
Provider Name (Legal Business Name): CHARLES T KAO D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/31/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date: 03/20/2006
Reactivation Date: 03/28/2006

III. Provider practice location address

333 W EL CAMINO REAL STE 110
SUNNYVALE CA
94087-1968
US

IV. Provider business mailing address

333 W EL CAMINO REAL STE 110
SUNNYVALE CA
94087-1968
US

V. Phone/Fax

Practice location:
  • Phone: 408-746-3770
  • Fax: 408-730-0025
Mailing address:
  • Phone: 408-746-3770
  • Fax: 408-730-0025

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number47375
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: