Provider Demographics
NPI:1225641293
Name:RICHARD T. KAO, DDS, PHD - DENTAL CORP.
Entity Type:Organization
Organization Name:RICHARD T. KAO, DDS, PHD - DENTAL CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:T
Authorized Official - Last Name:KAO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, PHD
Authorized Official - Phone:408-489-6395
Mailing Address - Street 1:5822 NEWGATE CT
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95138-2379
Mailing Address - Country:US
Mailing Address - Phone:408-489-6395
Mailing Address - Fax:
Practice Address - Street 1:1660 WILLOW ST STE 3
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95125-5101
Practice Address - Country:US
Practice Address - Phone:408-269-1060
Practice Address - Fax:408-516-8994
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-28
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty