Provider Demographics
NPI:1598973026
Name:TAI K. MAO DDS, INC.
Entity Type:Organization
Organization Name:TAI K. MAO DDS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TAI
Authorized Official - Middle Name:K
Authorized Official - Last Name:MAO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:626-286-3033
Mailing Address - Street 1:9925 LAS TUNAS DR.
Mailing Address - Street 2:
Mailing Address - City:TEMPLE CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91780
Mailing Address - Country:US
Mailing Address - Phone:626-286-3033
Mailing Address - Fax:626-286-3661
Practice Address - Street 1:9925 LAS TUNAS DR
Practice Address - Street 2:
Practice Address - City:TEMPLE CITY
Practice Address - State:CA
Practice Address - Zip Code:91780-2211
Practice Address - Country:US
Practice Address - Phone:626-286-3033
Practice Address - Fax:626-286-3661
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA49935305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service