Provider Demographics
NPI:1295975019
Name:DAO, KIEU-TRINH THI (DDS)
Entity type:Individual
Prefix:DR
First Name:KIEU-TRINH
Middle Name:THI
Last Name:DAO
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 1:12801 MIDWAY RD STE 401
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75244-6829
Mailing Address - Country:US
Mailing Address - Phone:214-232-5062
Mailing Address - Fax:
Practice Address - Street 1:4431 W WALNUT ST STE A
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75042-4108
Practice Address - Country:US
Practice Address - Phone:972-485-1200
Practice Address - Fax:972-485-1211
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-06
Last Update Date:2009-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX166971223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice