Provider Demographics
NPI:1235405200
Name:LINDA CAO DDS,LLC
Entity Type:Organization
Organization Name:LINDA CAO DDS,LLC
Other - Org Name:SMILE BRIGHT PEDIATRIC DENTAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PEDIATRIC DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:CAO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:504-207-0314
Mailing Address - Street 1:2744 MANHATTAN BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:HARVEY
Mailing Address - State:LA
Mailing Address - Zip Code:70058-6165
Mailing Address - Country:US
Mailing Address - Phone:504-207-0314
Mailing Address - Fax:504-609-3727
Practice Address - Street 1:2744 MANHATTAN BLVD STE A
Practice Address - Street 2:
Practice Address - City:HARVEY
Practice Address - State:LA
Practice Address - Zip Code:70058-6165
Practice Address - Country:US
Practice Address - Phone:504-207-0314
Practice Address - Fax:504-609-3727
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-23
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA55981223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA3192241Medicaid
LA3447649Medicaid