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PON T TATH D.M.D.
NPI 1225260623
Dentist - General Practice in Boonville, CA

Active since August 18, 2009
13500 AIRPORT RD, BOONVILLE, CA 95415(707) 895-3477(707) 895-2035 Get Directions Write a Review

NPPES record last updated: December 9, 2019. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Dec 9, 2019, Dec 18, 2015 (2 updates tracked since 2015).

About Pon T Tath D.m.d. NPPES

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

PON T TATH D.M.D. (NPI 1225260623) is an individual general practice provider in Boonville, California, licensed in California (58706) and active in the NPI registry since August 2009. He maintains a secondary practice location in Lathrop.

NPPES Registry Identity

NPI1225260623
Entity TypeIndividualMale
Primary Taxonomy1223G0001X
Provider Legal NamePON T TATHCredential: D.M.D.
Location Address13500 AIRPORT RDBoonville, CA 95415-9133
Mailing AddressPo Box 7783Stockton, CA 95267-0783 · (209) 597-3145 · Fax (707) 895-2035
Phone(707) 895-3477
Fax(707) 895-2035
Sole ProprietorNo
Enumeration DateAugust 18, 2009
Last NPPES UpdateDecember 9, 20192 updates tracked since enumeration
✔ NPI 1225260623 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in CA · 58706
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
13500 AIRPORT RD, Boonville, CA 95415
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Secondary Practice Location 1

Location 1220 Towne Centre DrLathrop, CA 95330-9533 · Phone (209) 597-3145

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and more.Insurance ›

Other Providers at the Same Location NPPES 7

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

MELANIE FULLER L.AC.
Acupuncturist
13500 AIRPORT RD
BOONVILLE, CA 95415
Mendocino County (707) 895-3477
GABRIELA ESPINOZA
Dental Hygienist
13500 AIRPORT RD
BOONVILLE, CA 95415
Mendocino County (707) 895-3477
ANDERSON VALLEY AMBULANCE SERVICE
Ambulance
13500 AIRPORT RD
BOONVILLE, CA 95415
Mendocino County (707) 895-3123
DR. CARY LYNN SMELTZER D.O.
Family Medicine
13500 AIRPORT RD
BOONVILLE, CA 95415
Mendocino County (707) 895-3477
CYD BERNSTEIN LCSW
Social Worker (Clinical)
13500 AIRPORT RD
BOONVILLE, CA 95415
Mendocino County (707) 895-3477
DR. STEPHANIE SHREVE PSY.D.
Psychologist (Clinical)
13500 AIRPORT RD
BOONVILLE, CA 95415
Mendocino County (707) 895-3477
MRS. TONI MARIE MANN DDS
Dentist
13500 AIRPORT RD
BOONVILLE, CA 95415
Mendocino County (707) 895-3477

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 Pon Tath's NPI number?

The NPI number for Pon Tath is 1225260623. It was assigned to this individual provider in the NPPES registry on August 18, 2009.

Where is Pon Tath located?

Pon Tath practices at 13500 Airport Rd, Boonville, CA 95415. The listed phone number is (707) 895-3477.

What is Pon Tath's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

What insurance does Pon Tath accept?

Health plans from Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and Humana and 1 other insurer list Pon Tath as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Pon Tath was last updated on December 9, 2019. NPI Profile syncs with the weekly NPPES data releases published by CMS.