Healthcare Provider Details

I. General information

NPI: 1023375342
Provider Name (Legal Business Name): VANESSA M CAO DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2012
Last Update Date: 06/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

151 CLINT DR SUITE 300
PICKERINGTON OH
43147-7749
US

IV. Provider business mailing address

151 CLINT DR SUITE 300
PICKERINGTON OH
43147-7749
US

V. Phone/Fax

Practice location:
  • Phone: 614-575-1155
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number30.023907
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: