Healthcare Provider Details

I. General information

NPI: 1528139235
Provider Name (Legal Business Name): DUYEN T DAO D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/13/2006
Last Update Date: 02/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1225 JEFFERSON RD
ROCHESTER NY
14623-3163
US

IV. Provider business mailing address

5 ELATIA CIR
PITTSFORD NY
14534-9520
US

V. Phone/Fax

Practice location:
  • Phone: 585-424-5240
  • Fax:
Mailing address:
  • Phone: 585-381-0514
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number0397071
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: