Provider Demographics
NPI:1689849929
Name:CHAO DENTAL CORPORATION
Entity type:Organization
Organization Name:CHAO DENTAL CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:C
Authorized Official - Last Name:CHAO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:626-308-9104
Mailing Address - Street 1:100 S 1ST ST
Mailing Address - Street 2:
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91801-3703
Mailing Address - Country:US
Mailing Address - Phone:626-308-9104
Mailing Address - Fax:626-284-8584
Practice Address - Street 1:100 S 1ST ST
Practice Address - Street 2:
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91801-3703
Practice Address - Country:US
Practice Address - Phone:626-308-9104
Practice Address - Fax:626-284-8584
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-28
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAD193331223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty