Active NPI
Elaine Khue Thai, DDS
- General Practice Dentistry
- Buena Park, CA
National Provider Identifier
1053965707
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 104199
- Practice address
- 7540 Orangethorpe Ave Ste A1
Buena Park, CA 90621-3458 - Phone
- (714) 576-2540
- NPI assigned
- Jul 31, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 104199 | CA | Primary |
Addresses
Primary practice location
7540 Orangethorpe Ave Ste A1
Buena Park, CA 90621-3458
Mailing address
7540 Orangethorpe Ave Ste A1
Buena Park, CA 90621-3458
Phone (714) 576-2540
Other practice location 1
17188 Colima Rd Ste C
Hacienda Heights, CA 91745-6787
Phone (626) 581-7878
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20201106002521 | CA | Order and Referring Only - Dentist | 7618387358 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 104199 | CA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Swati Shetty Dental Corporation | 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 and National Provider Directory roles.
-
- Dentist
- Buena Park, CA
- NPI 1023515558
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1564531200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1636848000000",
"number": "1053965707",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7540 ORANGETHORPE AVE STE A1",
"city": "BUENA PARK",
"state": "CA",
"postal_code": "906213458",
"telephone_number": "714-576-2540"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7540 ORANGETHORPE AVE STE A1",
"city": "BUENA PARK",
"state": "CA",
"postal_code": "906213458",
"telephone_number": "714-576-2540"
}
],
"practiceLocations": [
{
"address_1": "17188 Colima Rd Ste C",
"address_purpose": "LOCATION",
"city": "Hacienda Heights",
"state": "CA",
"postal_code": "917456787",
"country_code": "US",
"telephone_number": "626-581-7878",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "THAI",
"first_name": "ELAINE",
"middle_name": "KHUE",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-07-31",
"last_updated": "2021-11-14",
"certification_date": "2020-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "104199",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Buena Park, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.