Provider Demographics
NPI:1164514220
Name:ANTHONY HUNG CAO DDS A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:ANTHONY HUNG CAO DDS A PROFESSIONAL CORPORATION
Other - Org Name:BRIGHTER SMILE DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:HUNG
Authorized Official - Last Name:CAO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:949-646-1650
Mailing Address - Street 1:2200 HARBOR BLVD
Mailing Address - Street 2:STE B230
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92627
Mailing Address - Country:US
Mailing Address - Phone:949-646-1650
Mailing Address - Fax:949-646-1576
Practice Address - Street 1:2200 HARBOR BLVD
Practice Address - Street 2:STE B230
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92627
Practice Address - Country:US
Practice Address - Phone:949-646-1650
Practice Address - Fax:949-646-1576
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2019-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA43909122300000X
261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
No122300000XDental ProvidersDentistGroup - Multi-Specialty