Healthcare Provider Details

I. General information

NPI: 1558009860
Provider Name (Legal Business Name): HOA THI-THANH CAO DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2022
Last Update Date: 05/25/2022
Certification Date: 05/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

909 W ESPLANADE AVE STE 101
KENNER LA
70065-2700
US

IV. Provider business mailing address

22 GAINSWOOD DR E
MARRERO LA
70072-5068
US

V. Phone/Fax

Practice location:
  • Phone: 504-464-0202
  • Fax:
Mailing address:
  • Phone: 504-388-9971
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number7304
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: