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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

ETHAN THIEN TA DMD
NPI 1376432302
Dentist in Fpo, AP

Active since July 02, 2025

NPPES record last updated: August 24, 2026. Verified against the NPPES registry weekly; last sync: September 06, 2026.

Record update history: Aug 24, 2026, Jul 2, 2025 (2 updates tracked since 2025).

About Ethan Thien Ta Dmd NPPES

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

ETHAN THIEN TA DMD (NPI 1376432302) is an individual dentist in Fpo, AP, licensed in California (111703) and active in the NPI registry since July 2025.

NPPES Registry Identity

NPI1376432302
Entity TypeIndividualMale
Primary Taxonomy122300000X
Provider Legal NameETHAN THIEN TACredential: DMD
Location AddressPSC 475 BOX 1Fpo, AP 96350-1200
Mailing Address15290 Dundee AveApple Valley, MN 55124-5889 · (952) 649-1301
Phone(315) 243-7144
Sole ProprietorNo
Enumeration DateJuly 2, 2025
Last NPPES UpdateAugust 24, 20262 updates tracked since enumeration
NPPES CertifiedAugust 24, 2026
✔ NPI 1376432302 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License✔ Licensed in CA · 111703
Definition
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

Other Providers at the Same Location NPPES 20

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

DR. ANTHONY JAMES MARIN D.D.S.
Dentist (Endodontics)
PSC 475 BOX 1
FPO, AP 96350
(315) 243-5069
JASON PAUL JENSEN OTR/L, CHT
Occupational Therapist
PSC 475 BOX 1
FPO, AP 96350
(315) 243-5348
ANDREA L HAYES MSH, RD/RN
Dietitian, Registered
PSC 475 BOX 1
FPO, AP 96350
(315) 243-8658
MR. SAMUEL FOSTER OT
Occupational Therapist
PSC 475 BOX 1
FPO, AP 96350
(315) 253-4562
KIRSTEN LEANNE SANDOVAL
Occupational Therapist
PSC 475 BOX 1
FPO, AP 96350
(818) 277-9111
DR. MIRIAM BEHPOUR DMD
Dentist (General Practice)
PSC 475 BOX 1
FPO, AP 96350
(315) 243-7144
MR. SEBASTIAN NMN STACHOWICZ CRNA
Nurse Anesthetist, Certified Registered
PSC 475 BOX 1
FPO, AP 96350
(619) 532-6400
PHILIP DEAN PETERSON MD
Pathology (Anatomic Pathology & Clinical Pathology)
PSC 475 BOX 1
FPO, AP 96350
(315) 243-8560

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 Ethan Ta's NPI number?

The NPI number for Ethan Ta is 1376432302. It was assigned to this individual provider in the NPPES registry on July 2, 2025.

Where is Ethan Ta located?

Ethan Ta practices at Psc 475 Box 1, Fpo, AP 96350. The listed phone number is (315) 243-7144.

What is Ethan Ta's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

When was this NPI record last updated?

The NPPES record for Ethan Ta was last updated on August 24, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 days 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.