Provider Demographics
NPI:1295937811
Name:HOANGSON DAO DDS & MICHAEL DAO DMD
Entity type:Organization
Organization Name:HOANGSON DAO DDS & MICHAEL DAO DMD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRIMARY DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:TUAN
Authorized Official - Last Name:DAO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:714-785-1352
Mailing Address - Street 1:125 E COMPTON BLVD
Mailing Address - Street 2:
Mailing Address - City:COMPTON
Mailing Address - State:CA
Mailing Address - Zip Code:90220-2410
Mailing Address - Country:US
Mailing Address - Phone:310-856-0687
Mailing Address - Fax:310-856-0689
Practice Address - Street 1:125 E COMPTON BLVD
Practice Address - Street 2:
Practice Address - City:COMPTON
Practice Address - State:CA
Practice Address - Zip Code:90220-2410
Practice Address - Country:US
Practice Address - Phone:310-856-0687
Practice Address - Fax:310-856-0689
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-05
Last Update Date:2007-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACA439311223G0001X
CACA467761223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty