Tae Kyun Ha, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

105470 Issued in CA

Practice address

12271 La Mirada Blvd Ste 201
La Mirada, CA 90638-1336

Phone

(562) 445-3555

NPI assigned

Oct 8, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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.

• Danoukh Dental Corp.

  • General Practice Dentistry
  • La Mirada, CA
  • NPI 1124686233
  NPD (past)

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

{
    "created_epoch": "1602115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602115200000",
    "number": "1225635600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4813 OAKWOOD AVE UNIT 104",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900043559",
            "telephone_number": "818-445-1899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12271 LA MIRADA BLVD STE 201",
            "city": "LA MIRADA",
            "state": "CA",
            "postal_code": "906381336",
            "telephone_number": "562-445-3555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HA",
        "first_name": "TAE KYUN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-08",
        "last_updated": "2020-10-08",
        "certification_date": "2020-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "105470",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "105470",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Green
• Heather Renee Green, LPCC
• Jessica Amparo Guerrero
• Ruby Guillen
• Louie Martin Gunderson
• Miriam Elizabeth Lewis Hall, PH.D.
• Sarah Hall, RD, IBCLC
• Todd W Hall, PHD
• Aaron James Hamilton, D.C.
• Sharon Han, DDS

• Dentist in La Mirada, CA
• Providers in La Mirada, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2020; 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.