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MICHELLE TA DMD
NPI 1124643739
Dentist - Pediatric Dentistry in San Rafael, CA

Active since June 09, 2020
912 GRAND AVE STE 202, SAN RAFAEL, CA 94901(408) 717-0888 Get Directions Write a Review

NPPES record last updated: June 9, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Michelle Ta Dmd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MICHELLE TA DMD (NPI 1124643739) is an individual pediatric dentistry provider in San Rafael, California, licensed in California (DDS104671) and active in the NPI registry since June 2020.

NPPES Registry Identity

NPI1124643739
Entity TypeIndividualFemale
Primary Taxonomy1223P0221X
Provider Legal NameMICHELLE TACredential: DMD
Location Address912 GRAND AVE STE 202San Rafael, CA 94901-3552
Mailing Address77 Tennant AveSan Jose, CA 95138-1851
Phone(408) 717-0888
Sole ProprietorNo
Enumeration DateJune 9, 2020
NPPES CertifiedJune 9, 2020
✔ NPI 1124643739 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Pediatric DentistryDental Providers
Taxonomy Code1223P0221X
License✔ Licensed in CA · DDS104671
Definition
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
912 GRAND AVE STE 202, San Rafael, CA 94901
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Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. APARNA AGHI DMD
Dentist (Pediatric Dentistry)
912 GRAND AVE STE 202
SAN RAFAEL, CA 94901
Marin County (415) 459-1444
DR. MARTIN SINAI RAYMAN DDS
Dentist (Pediatric Dentistry)
912 GRAND AVE STE 202
SAN RAFAEL, CA 94901
Marin County (415) 459-1444

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Michelle Ta's NPI number?

The NPI number for Michelle Ta is 1124643739. It was assigned to this individual provider in the NPPES registry on June 9, 2020.

Where is Michelle Ta located?

Michelle Ta practices at 912 Grand Ave Ste 202, San Rafael, CA 94901. The listed phone number is (408) 717-0888.

What is Michelle Ta's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Pediatric Dentistry, with taxonomy code 1223P0221X.

When was this NPI record last updated?

The NPPES record for Michelle Ta was last updated on June 9, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.