Brandon Tuan Thai, DDS
Individual provider Active NPI General Practice Dentistry · Saugus, CA
NPI 1053481663 · NPPES record last updated Dec 10, 2015
Key facts
- NPI
- 1053481663
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 49227 (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
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151223001933 | CA | Order and Referring Only - Other (Non-Physician) | 1355642901 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 49227 | CA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brandon Thai DDS, Inc | General Practice | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 49227 | CA | Yes |
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
Other providers in Saugus, CA
- Paula Ines Rosello
- Chauncey Salman
- Connie Ann Shannon
- Sheela Kalberg Simkins
- Jessica Somers
- The Vision Center an Optometric Practice Incorporated
- Sharese Torres
- Han Tran
- Aya Tsuchimochi-Cruz
- U.S. Healthworks Medical Group -Saugus
All providers in Saugus, CA · General Practice Dentistry in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 10, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.