Tantra Djaya, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

33277 Issued in CA

Practice address

9316 Painter Ave
Whittier, CA 90605-2727

Phone

(562) 945-9493

Fax

(562) 693-8781

NPI assigned

Feb 20, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Tantra Djaya Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1249516800000",
    "number": "1699810325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9316 PAINTER AVE",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "906052727",
            "telephone_number": "562-945-9493",
            "fax_number": "562-693-8781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9316 PAINTER AVE",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "906052727",
            "telephone_number": "562-945-9493",
            "fax_number": "562-693-8781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DJAYA",
        "first_name": "TANTRA",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-20",
        "last_updated": "2009-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "33277",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTICAL",
            "identifier": "D33277",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "969806",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TANTRA",
            "last_name": "DJAYA",
            "credential": "DDS",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Andrea Dixon
• Monica Dixon
• Rebecca Anne Dixon
• Caleb Dizon, FNP-C
• Andrew Djaya, DDS
• Anh DO
• Kassie DO
• Kimberly Dawn Manzano Doctolero
• Doctors Convalescent Hospital
• Jean Doerfler, CA NHA 5826

• Dentist in Whittier, CA
• Providers in Whittier, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2009; 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.