NPIMap

Organization Active NPI

Nguyen and Ta Professional Dental Corp.

Doing business as Thai Ta, DDS

  • Periodontics
  • West Covina, CA
National Provider Identifier
1942370317
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
45530 Issued in CA
Legal business name
NGUYEN AND TA PROFESSIONAL DENTAL CORP.
Doing business as
Thai Ta, DDS
Practice address
1740 W Cameron Ave Ste 106
West Covina, CA 91790-2719
Phone
(626) 337-4440
Fax
(626) 337-4460
NPI assigned
Nov 9, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Thai Thuy Ta, DDSNPI 1003953563
Title
Secretary
Phone
(626) 337-4440

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 45530 CA Primary

Addresses

Primary practice location

1740 W Cameron Ave Ste 106
West Covina, CA 91790-2719

Mailing address

1740 W Cameron Ave Ste 106
West Covina, CA 91790-2719
Phone (626) 337-4440

Other names 1

  • Thai Ta, DDS Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Allan Nguyen DDS Ms3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1740 W Cameron Ave
Ste 106
West Covina, CA 91790
Phone (626) 337-4440

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1942370317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1740 W CAMERON AVE STE 106",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917902719",
            "telephone_number": "626-337-4440",
            "fax_number": "626-337-4460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1740 W CAMERON AVE STE 106",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917902719",
            "telephone_number": "626-337-4440",
            "fax_number": "626-337-4460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NGUYEN AND TA PROFESSIONAL DENTAL CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TA",
        "authorized_official_first_name": "THAI",
        "authorized_official_middle_name": "THUY",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "626-337-4440",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "45530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Thai Ta, DDS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in West Covina, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.