Jason Hien Ta, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

55067 Issued in CA

Practice address

2111 S Atlantic Blvd
Monterey Park, CA 91754-6801

Phone

(323) 261-9999

Fax

(323) 260-7680

NPI assigned

Aug 15, 2007

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Central Dental Group

  • General Practice Dentistry
  • Monterey Park, CA
  • NPI 1245308923
  NPD (past)
• Ryan S C Lee,a Professional Dental Corporation

  • Dentist
  • Monterey Park, CA
  • NPI 1225430473
  NPD (past)

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

{
    "created_epoch": "1187136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187136000000",
    "number": "1023200979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10138 LANETT AVE",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "906053313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2111 S ATLANTIC BLVD",
            "city": "MONTEREY PARK",
            "state": "CA",
            "postal_code": "917546801",
            "telephone_number": "323-261-9999",
            "fax_number": "323-260-7680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TA",
        "first_name": "JASON",
        "middle_name": "HIEN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-15",
        "last_updated": "2007-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "55067",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL BOARD OF CALIFORNI",
            "identifier": "55067",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephanie Minh Sy
• Synergy Physician Group Inc
• Synesthesia Medical Associates Inc.
• Sze-Wai NG, M.D., a Professional Corporation
• T L Pharmacy Inc
• Tai S. Chang, M.D. a Medical Corporation
• Liang-Yu Laura Tai, D.O.
• Edna K Taikwel, M.D.
• Sieng Taing, PHARMD
• Thomas Tam, M.D.

• Dentist in Monterey Park, CA
• Providers in Monterey Park, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.