Provider Demographics
NPI:1104059989
Name:CHAO, IRVING I (DDS)
Entity type:Individual
Prefix:DR
First Name:IRVING
Middle Name:I
Last Name:CHAO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1211 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93901-2205
Mailing Address - Country:US
Mailing Address - Phone:831-424-1535
Mailing Address - Fax:831-424-0953
Practice Address - Street 1:1211 S MAIN ST
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-2205
Practice Address - Country:US
Practice Address - Phone:831-424-1535
Practice Address - Fax:831-424-0953
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-27
Last Update Date:2020-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA586611223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice