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General NPI Number Information
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NPI Number | 1912099110
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Entity Type | Individual
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Provider Name | DAVID MAO D.D.S., P.H.D.
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Gender | Male
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Dates
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Enumeration Date | 09/28/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 4260 MAIN ST SUITE A
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City | FLUSHING
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State | NY
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Zip | 11355-4741
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Country | US
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Telephone | 718-321-3755
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Fax | 718-762-6718
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Provider Business Mailing Address
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Address Line | 4974 175TH PL
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City | FRESH MEADOWS
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State | NY
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Zip | 11365-1624
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Country | US
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Telephone | 718-537-5000
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 041706
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 041706
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License Number State | NY
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