Phuong-Thao Thi Dao, D.D.S

Individual provider Active NPI General Practice Dentistry · Paramount, CA

NPI 1003124264 · NPPES record last updated Sep 1, 2016

Key facts

NPI
1003124264
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
59831 (CA)
Practice address
15717 Paramount Blvd
Suite C
Paramount, CA 90723-4377
Phone
(562) 602-1200
NPI assigned
Sep 21, 2010
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
59831CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Hung Dang DDS Inc. Past
since Apr 27, 2015
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 59831 CA Yes

Addresses

Primary practice location

15717 Paramount Blvd
Suite C
Paramount, CA 90723-4377

Mailing address

14700 Van Ness Ave
Gardena, CA 90249-3700
Phone (310) 516-0271

Other providers in Paramount, CA

All providers in Paramount, CA · General Practice Dentistry in California

Sources for this page

Verify at the official NPI Registry.