Provider Demographics
NPI:1942839766
Name:CAO, THO (DMD)
Entity Type:Individual
Prefix:
First Name:THO
Middle Name:
Last Name:CAO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 CHARLOTTE ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64106-1215
Mailing Address - Country:US
Mailing Address - Phone:404-441-8892
Mailing Address - Fax:
Practice Address - Street 1:2180 W DARTMOUTH ST
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66061-6690
Practice Address - Country:US
Practice Address - Phone:913-732-9408
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-03
Last Update Date:2020-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN016014.1223G0001X
KS617011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice