Individual provider Active NPI

Anna A Dao, DMD

  • Dentist
  • Davenport, FL
National Provider Identifier
1043986359
Registry record updated Mar 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
26313 Issued in FL
Practice address
39863 Highway 27
Davenport, FL 33837-7802
Phone
(863) 216-3369
Fax
(863) 216-3368
NPI assigned
Aug 17, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 4547 AR
Dentist 122300000X 26313 FL Primary

Addresses

Primary practice location

39863 Highway 27
Davenport, FL 33837-7802

Mailing address

39863 Highway 27
Davenport, FL 33837-7802
Phone (863) 216-3369

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
4547ARMDDentist
26313FLMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Arkansas Dental Professionals Mongrain PA CurrentSince Aug 1, 2021 Accepting new patients
Dao-Nguyen DMD PA CurrentSince Mar 3, 2024 Accepting new patients

Locations

2909 S 74th St
Fort Smith, AR 72903
Phone (479) 452-7454

39863 Highway 27
Davenport, FL 33837
Phone (863) 216-3369

Organizations & group practices 2

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1629158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709251200000",
    "number": "1043986359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39863 HIGHWAY 27",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338377802",
            "telephone_number": "863-216-3369",
            "fax_number": "863-216-3368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39863 HIGHWAY 27",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338377802",
            "telephone_number": "863-216-3369",
            "fax_number": "863-216-3368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAO",
        "first_name": "ANNA",
        "middle_name": "A",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-17",
        "last_updated": "2024-03-01",
        "certification_date": "2024-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AR",
            "license": "4547",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "26313",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davenport, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.