Provider Demographics
NPI:1093939373
Name:CAO, LINDA THI (DDS)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:THI
Last Name:CAO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3330 KINGMAN ST STE 1
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70006-4235
Mailing Address - Country:US
Mailing Address - Phone:504-908-2098
Mailing Address - Fax:504-609-3727
Practice Address - Street 1:3330 KINGMAN ST STE 1
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-4235
Practice Address - Country:US
Practice Address - Phone:504-207-0314
Practice Address - Fax:504-609-3727
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA55981223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA3192241Medicaid
LA3447649Medicaid