TK Ly Dental Corporation

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

48322 Issued in CA

Legal business name

TK LY DENTAL CORPORATION

Practice address

2023 Harbor Blvd
Suite D
Costa Mesa, CA 92627-5552

Phone

(949) 646-9000

NPI assigned

Jan 5, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Tuankiet Quoc Ly, D.D.S

Title

President

Phone

(949) 646-9000

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• BAY MESA DENTAL OFFICE Doing business as

Locations

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

{
    "created_epoch": "1262649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262649600000",
    "number": "1679803241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2023 HARBOR BLVD",
            "address_2": "SUITE D",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926275552",
            "telephone_number": "949-646-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2023 HARBOR BLVD",
            "address_2": "SUITE D",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926275552",
            "telephone_number": "949-646-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TK LY DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-05",
        "last_updated": "2010-01-05",
        "status": "A",
        "authorized_official_last_name": "LY",
        "authorized_official_first_name": "TUANKIET",
        "authorized_official_middle_name": "QUOC",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-646-9000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "48322",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL BOARD OF CALIFORNIA",
            "identifier": "48322",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONAL PROVIDER IDENTIFIER",
            "identifier": "1043387228",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BAY MESA DENTAL OFFICE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tiev Medical Aesthetics, a Professional Medical Corporation
• Thomas James Tighe, MFT-I
• Amy Eleanis Tippol
• Akili Titus
• Mary Isabella Titus I, PSC 1
• Sarai Belen Tlachi
• Vincent To, DC
• Gracious Togiai
• Josephine Fuerte Togle
• Yessica Hannah Tojin

• General Practice Dentistry in Costa Mesa, CA
• Providers in Costa Mesa, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2010; 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.