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ETHAN THIEN TA DMD
NPI 1376432302
Dentist in Camp Pendleton, CA

Active since July 02, 2025
200 MERCY CIRCLE, CAMP PENDLETON, CA 92055(760) 725-5870 Get Directions Write a Review

NPPES record last updated: July 2, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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 Camp Pendleton, California, 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 Address200 MERCY CIRCLECamp Pendleton, CA 92055
Mailing Address4128 Rio Azul WayOceanside, CA 92057-3554 · (952) 649-1301
Phone(760) 725-5870
Sole ProprietorNo
Enumeration DateJuly 2, 2025
NPPES CertifiedJune 17, 2025
✔ 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.
200 MERCY CIRCLE, Camp Pendleton, CA 92055
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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.

MARIA J HERRERA PH.D.
Psychologist (Clinical)
200 MERCY CIRCLE
OCEANSIDE, CA 92055
San Diego County (510) 542-0859
SHERRI MARTINEZ LMFT, ADCII
Counselor (Addiction (Substance Use Disorder))
200 MERCY CIRCLE
CAMP PENDLETON, CA 92055
San Diego County (760) 725-0063
DR. ASHLEY BITTLE LCSW, PSY.D.
Psychologist (Clinical)
200 MERCY CIRCLE
CAMP PENDLETON, CA 92055
San Diego County (760) 719-3322
MISS KELLY CAROL PENG D.O
Military Health Care Provider
200 MERCY CIRCLE, EMERGENCY MEDICINE DEPARTMENT
OCEANSIDE, CA 92055
San Diego County (760) 719-3994
CAROLYN STEINLAGE DPT
Physical Therapist
200 MERCY CIRCLE
CAMP PENDLETON, CA 92055
San Diego County (760) 719-3791
SHANE MCGUIRE FMF RECON IDC
Military Health Care Provider (Independent Duty Corpsman)
200 MERCY CIRCLE
OCEANSIDE, CA 92055
San Diego County (760) 725-8912
MELINDA WEE FAH MARTINEZ PA
Physician Assistant
200 MERCY CIRCLE
CAMP PENDLETON, CA 92055
San Diego County (760) 719-4550
ALEXANDER JEFFREY NELSON PA-C
Physician Assistant
200 MERCY CIRCLE
OCEANSIDE, CA 92055
San Diego County (760) 725-1288

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 200 Mercy Circle, Camp Pendleton, CA 92055. The listed phone number is (760) 725-5870.

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 July 2, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months 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.