Individual provider Active NPI

Tin Latt, D.D.S

  • General Practice Dentistry
  • Monterey Park, CA
National Provider Identifier
1013092998
Registry record updated Jul 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
49354 Issued in CA
Practice address
883 S Atlantic Blvd Ste C
Monterey Park, CA 91754-4725
Phone
(626) 284-4200
Fax
(626) 284-4700
NPI assigned
Oct 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 49354 CA Primary

Addresses

Primary practice location

883 S Atlantic Blvd Ste C
Monterey Park, CA 91754-4725

Mailing address

883 S Atlantic Blvd Ste C
Monterey Park, CA 91754-4725
Phone (626) 284-4200

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20151218001775 CA Order and Referring Only - DentistPractitioner - Dentist 4688975519

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Tin Latt DDS Inc CurrentSince Aug 1, 2021 Accepting new patients
Tin Latt Current Accepting new patients

Locations

871 S Atlantic Blvd
Monterey Park, CA 91754
Phone (626) 284-4200

883 S Atlantic Blvd
Ste C
Monterey Park, CA 91754
Phone (626) 284-4200

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627171200000",
    "number": "1013092998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "883 S ATLANTIC BLVD STE C",
            "city": "MONTEREY PARK",
            "state": "CA",
            "postal_code": "917544725",
            "telephone_number": "626-284-4200",
            "fax_number": "626-284-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "883 S ATLANTIC BLVD STE C",
            "city": "MONTEREY PARK",
            "state": "CA",
            "postal_code": "917544725",
            "telephone_number": "626-284-4200",
            "fax_number": "626-284-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LATT",
        "first_name": "TIN",
        "name_prefix": "Mr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-26",
        "last_updated": "2021-07-25",
        "certification_date": "2021-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "49354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monterey Park, CA

Sources for this page

Verify at the official NPI Registry.