Individual provider Active NPI

Tai Ha, DDS

  • Dentist
  • Newport Beach, CA
National Provider Identifier
1053778712
Registry record updated Dec 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
65341 Issued in CA
Practice address
1441 Avocado Ave Ste 404
Newport Beach, CA 92660-7705
Phone
(949) 706-7097
NPI assigned
Jan 26, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 65341 CA Primary

Addresses

Primary practice location

1441 Avocado Ave Ste 404
Newport Beach, CA 92660-7705

Mailing address

1441 Avocado Ave Ste 404
Newport Beach, CA 92660-7705
Phone (949) 706-7097

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
I20170110000621 CA Order and Referring Only - DentistPractitioner - Dentist 1658652482

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
65341CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Ha Dental Corp. CurrentSince Jun 19, 2020 Accepting new patients

Locations

1441 Avocado Ave
Ste 404
Newport Beach, CA 92660
Phone (949) 644-4116

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1453766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670198400000",
    "number": "1053778712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1441 AVOCADO AVE STE 404",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926607705",
            "telephone_number": "949-706-7097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 AVOCADO AVE STE 404",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926607705",
            "telephone_number": "949-706-7097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HA",
        "first_name": "TAI",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-01-26",
        "last_updated": "2022-12-05",
        "certification_date": "2022-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "65341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

Verify at the official NPI Registry.