Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1376432302 Individual Practitioner Male Practitioner

Dr. Ethan Thien Ta , DMD

Dentist • Camp Pendleton, CA

Professional Overview & Biography Verified Profile Summary

Dr. Ethan Ta, DMD is a registered healthcare professional specializing in Dentist in Camp Pendleton, CA. Practice services are available at 200 MERCY CIRCLE under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

200 Mercy Circle

Camp Pendleton, CA 92055

Telephone 7607255870
Associated Practice Facility / Clinic
🏢 Nh Camp Pendleton Facility NPI 1386604387

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist in Camp Pendleton, CA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 14.4 Yrs
Regional Practice Density
39 Specialists

Practicing in Camp Pendleton, CA (15331 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2025-06-17
Dentist Primary Specialty

NUCC Taxonomy Code: 122300000X

State License CA 111703

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.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

12 Associated Practitioners
NPI 1003423260

Registered Dental Hygienist

NPI 1023632676

DENTALSTUDENT

Connie Good

Dental Hygienist

NPI 1194325597
Cynthia Knode , RDA

Dental Assistant

NPI 1396352555
NPI 1407428543

Doctor of Dental Medicine

Dora Young

Dental Assistant

NPI 1528675980

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active July 02, 2025

NPI status registered as active in NPPES database

📍
Updated Practice Location July 02, 2025

Registered at 200 MERCY CIRCLE, CAMP PENDLETON, CA 92055 (Tel: 7607255870)

📍
Updated Business Mailing Address July 02, 2025

Registered at 4128 RIO AZUL WAY, OCEANSIDE, CA 920573554 (Tel: 9526491301)

👤
Provider Name / Credentials Updated July 02, 2025

Recorded as ETHAN TA, DMD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 02, 2025

Dentist (License #111703 in CA)

🟢
Initial NPI Registration & Enumeration July 02, 2025

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1376432302
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 02, 2025
Last Update: July 02, 2025
Sole Proprietor: No

Mailing Address

4128 Rio Azul Way

Oceanside, CA 920573554

Phone: 9526491301

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.