Active NPI
Thay Kieu, RDH
- Dental Hygienist
- Menifee, CA
National Provider Identifier
1598200040
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 24963
- Practice address
- 30035 Haun Rd
Menifee, CA 92584 - Phone
- (951) 566-9090
- NPI assigned
- Dec 19, 2016
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 24963 | CA | Primary |
Addresses
Primary practice location
30035 Haun Rd
Menifee, CA 92584
Mailing address
30035 Haun Rd
Menifee, CA 92584-6805
Phone (951) 566-9090
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 24963 | Medicaid | CA |
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 |
|---|---|---|---|
| 24963 | CA | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1482105600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1486598400000",
"number": "1598200040",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30035 HAUN RD",
"city": "MENIFEE",
"state": "CA",
"postal_code": "925846805",
"telephone_number": "951-566-9090"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30035 HAUN RD",
"city": "MENIFEE",
"state": "CA",
"postal_code": "92584",
"telephone_number": "951-566-9090"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIEU",
"first_name": "THAY",
"credential": "RDH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-12-19",
"last_updated": "2017-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "CA",
"license": "24963",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "24963",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Menifee, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.