Active NPI
Mikhai Cong Ta, DDS
- Dentist
- Paradise, CA
National Provider Identifier
1316950926
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 102306
- Practice address
- 5734 Canyon View Dr
Paradise, CA 95969-5503 - Phone
- (530) 876-7179
- NPI assigned
- Aug 14, 2006
- Last updated
- Oct 3, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 10476 | WA | |
| Dentist | 122300000X | 102306 | CA | Primary |
Addresses
Primary practice location
5734 Canyon View Dr
Paradise, CA 95969-5503
Mailing address
5734 Canyon View Dr
Paradise, CA 95969-5503
Other practice location 1
709 Harrison Ave
Centralia, WA 98531
Phone (360) 736-5040
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1852977 | Other | WA | UNITED CONCORDIA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 102306 | CA | MD | Marriage & Family Therapist |
| 10476 | WA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155513600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1538524800000",
"number": "1316950926",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5734 CANYON VIEW DR",
"city": "PARADISE",
"state": "CA",
"postal_code": "959695503"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5734 CANYON VIEW DR",
"city": "PARADISE",
"state": "CA",
"postal_code": "959695503",
"telephone_number": "530-876-7179"
}
],
"practiceLocations": [
{
"address_1": "709 Harrison Ave",
"address_purpose": "LOCATION",
"city": "Centralia",
"state": "WA",
"postal_code": "98531",
"country_code": "US",
"telephone_number": "360-736-5040",
"fax_number": "360-736-1979",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TA",
"first_name": "MIKHAI",
"middle_name": "CONG",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-14",
"last_updated": "2018-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WA",
"license": "10476",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "102306",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED CONCORDIA",
"identifier": "1852977",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Paradise, CA
- Sunshine Homecare and Hospice of Butte County
- Sunshine Homecare and Hospice of Butte County
- Sunshine Village of Paradise, a California Corporation (Sunshine Assisted Living - The Cottage)
- Jadie Joan Swietanski, FNP-BC
- Valerie Leigh Sykes, SLP
- Robert Matthews Tatum, LCSW
- David Ralph Terstegen, COTA
- The Best Place for Moms LLC
- Thomas Stewart MD Inc
- Brandy Nicole Thomas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.