Provider Demographics
NPI:1235817685
Name:KAO, PEICHI (DDS)
Entity Type:Individual
Prefix:
First Name:PEICHI
Middle Name:
Last Name:KAO
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 1:12627 SE 26TH PL
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98005-4336
Mailing Address - Country:US
Mailing Address - Phone:425-615-4550
Mailing Address - Fax:
Practice Address - Street 1:1918 152ND AVE NE
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98007-4880
Practice Address - Country:US
Practice Address - Phone:206-498-2212
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-06
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE61439326122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist