Active NPI
Alice H Tai, DDS
- Periodontics
- San Ramon, CA
National Provider Identifier
1760593933
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 38464
- Practice address
- 525 Bollinger Canyon Way
Suite 103
San Ramon, CA 94582-4935 - Phone
- (925) 735-1881
- Fax
- (925) 735-1440
- NPI assigned
- Aug 31, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 38464 | CA | Primary |
Addresses
Primary practice location
525 Bollinger Canyon Way
Suite 103
San Ramon, CA 94582-4935
Mailing address
525 Bollinger Canyon Way Ste 103
San Ramon, CA 94582-4935
Phone (925) 735-1881
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Mar 15, 2018 through Mar 15, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1602547200000",
"number": "1760593933",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "525 BOLLINGER CANYON WAY STE 103",
"city": "SAN RAMON",
"state": "CA",
"postal_code": "945824935",
"telephone_number": "925-735-1881",
"fax_number": "925-735-1440"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "525 BOLLINGER CANYON WAY",
"address_2": "SUITE 103",
"city": "SAN RAMON",
"state": "CA",
"postal_code": "945824935",
"telephone_number": "925-735-1881",
"fax_number": "925-735-1440"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAI",
"first_name": "ALICE",
"middle_name": "H",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-31",
"last_updated": "2020-10-13",
"certification_date": "2020-10-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "CA",
"license": "38464",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Ramon, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.