Healthcare Provider Details

I. General information

NPI: 1518604289
Provider Name (Legal Business Name): JASON DAO DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2022
Last Update Date: 11/01/2023
Certification Date: 11/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

903 N ARENDELL AVE
ZEBULON NC
27597-2307
US

IV. Provider business mailing address

903 N ARENDELL AVE
ZEBULON NC
27597-2307
US

V. Phone/Fax

Practice location:
  • Phone: 919-793-5009
  • Fax:
Mailing address:
  • Phone: 919-793-5009
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number13438
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: