Individual provider Active NPI

Brandon Tuan Thai, DDS

  • General Practice Dentistry
  • Saugus, CA
National Provider Identifier
1053481663
Registry record updated Dec 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
49227 Issued in CA
Practice address
28100 Bouquet Canyon Rd 200
Saugus, CA 91350-2006
Phone
(661) 263-6923
Fax
(661) 263-9776
NPI assigned
Nov 9, 2006
Last updated
Dec 10, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2015

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 49227 CA Primary

Addresses

Primary practice location

28100 Bouquet Canyon Rd 200
Saugus, CA 91350-2006

Mailing address

28100 Bouquet Canyon Rd 200
Saugus, CA 91350-2006
Phone (661) 263-6923

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151223001933 CA Order and Referring Only - Other (Non-Physician) 1355642901

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Brandon Thai DDS, Inc General Practice Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449705600000",
    "number": "1053481663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28100 BOUQUET CANYON RD 200",
            "city": "SAUGUS",
            "state": "CA",
            "postal_code": "913502006",
            "telephone_number": "661-263-6923",
            "fax_number": "661-263-9776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28100 BOUQUET CANYON RD 200",
            "city": "SAUGUS",
            "state": "CA",
            "postal_code": "913502006",
            "telephone_number": "661-263-6923",
            "fax_number": "661-263-9776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THAI",
        "first_name": "BRANDON",
        "middle_name": "TUAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-09",
        "last_updated": "2015-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "49227",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saugus, CA

Sources for this page

Verify at the official NPI Registry.