Provider Demographics
NPI:1154546315
Name:GAO, TAO (DDS)
Entity type:Individual
Prefix:DR
First Name:TAO
Middle Name:
Last Name:GAO
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 1:105 FOREST VIEW PL
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-5824
Mailing Address - Country:US
Mailing Address - Phone:919-923-8714
Mailing Address - Fax:
Practice Address - Street 1:5318 NC HIGHWAY 55 STE 204
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-9660
Practice Address - Country:US
Practice Address - Phone:919-806-8218
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-14
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC76811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice