Provider Demographics
NPI:1972774263
Name:CHAO, SCOTT (DDS)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:
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 1:2835 35TH AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94116-2817
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:406 N SAN MATEO DR
Practice Address - Street 2:#B
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94401-2418
Practice Address - Country:US
Practice Address - Phone:650-342-8874
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-14
Last Update Date:2008-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA49072122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist