Thai Thuy Ta, D.D.S.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

45530 Issued in CA

Practice address

1740 W Cameron Ave Ste 106
West Covina, CA 91790-2719

Phone

(626) 337-4440

NPI assigned

Jan 31, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003953563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1740 W CAMERON AVE STE 106",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917902719",
            "telephone_number": "626-337-4440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1740 W CAMERON AVE STE 106",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917902719",
            "telephone_number": "626-337-4440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TA",
        "first_name": "THAI",
        "middle_name": "THUY",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "45530",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "G.G. DELTA",
            "identifier": "445530",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Robyn Swift
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• Claire Marie Tabares, FNP-C
• Ariana Linda Marie Tabler
• Tammy Lynn Tagge
• Albert Tai

• Periodontics in West Covina, CA
• Providers in West Covina, CA by specialty
• Periodontics in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.