Healthcare Provider Details

I. General information

NPI: 1962854497
Provider Name (Legal Business Name): JOSEPH KAO D.M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2016
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

377 CABOT ST
BEVERLY MA
01915-3390
US

IV. Provider business mailing address

729 FAITH DR
LIBERTY HILL TX
78642-2247
US

V. Phone/Fax

Practice location:
  • Phone: 978-838-3071
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN10001427
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number34597
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number30.24855
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: