Provider Demographics
NPI:1861825937
Name:CAO, QIAN HANNA (DDS)
Entity Type:Individual
Prefix:DR
First Name:QIAN
Middle Name:HANNA
Last Name:CAO
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 1:1313 WASHINGTON ST
Mailing Address - Street 2:430
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-2152
Mailing Address - Country:US
Mailing Address - Phone:508-733-8804
Mailing Address - Fax:
Practice Address - Street 1:332 WASHINGTON ST STE 330
Practice Address - Street 2:
Practice Address - City:WELLESLEY
Practice Address - State:MA
Practice Address - Zip Code:02481-6215
Practice Address - Country:US
Practice Address - Phone:781-237-6511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-13
Last Update Date:2019-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY056668122300000X
MADN1856754122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist