Tuan Phuong Cao, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019.033896 Issued in IL

Practice address

4641 W Diversey Ave
Chicago, IL 60639-1828

Phone

(773) 692-4147

NPI assigned

Jul 23, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Tuan Cao DDS PC

  • Dental Clinic/Center
  • Chicago, IL
  • NPI 1548077126
  NPD Authorized official

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

{
    "created_epoch": "1595462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661990400000",
    "number": "1306455654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4529 SAINT MARY ST",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700062029",
            "telephone_number": "504-458-1217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4641 W DIVERSEY AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606391828",
            "telephone_number": "773-692-4147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAO",
        "first_name": "TUAN",
        "middle_name": "PHUONG",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-07-23",
        "last_updated": "2022-09-01",
        "certification_date": "2022-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "LA",
            "license": "7091",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.033896",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Cao, MD
• David Boyan Cao
• Jessica Cao, MD
• Jessica Lu Cao, MD
• Nathan Van Cao
• Susan Capan, APN
• Mary Joan Psyche Santos Capaque
• Caper Children'S Services LLC
• Quinn Capers IV, M.D.
• Andrew Capesius, DPT

• General Practice Dentistry in Chicago, IL
• Providers in Chicago, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.