Healthcare Provider Details

I. General information

NPI: 1629385646
Provider Name (Legal Business Name): WENKAI KAO DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: DANIEL KAO DMD

II. Dates (important events)

Enumeration Date: 09/13/2010
Last Update Date: 12/13/2025
Certification Date: 12/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1180 BEACON ST STE 2C
BROOKLINE MA
02446-3806
US

IV. Provider business mailing address

1180 BEACON ST STE 2C
BROOKLINE MA
02446-3806
US

V. Phone/Fax

Practice location:
  • Phone: 617-860-1180
  • Fax:
Mailing address:
  • Phone: 617-860-1180
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License NumberDN1858592
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: