DR. PHONG CAM TA D.D.S. NPI 1861646747

NPI Information

DR. Phong Cam Ta, D.D.S. is a dentist anesthesiologist dentist in New York, NY. The provider is a dentist who has successfully completed an accredited postdoctoral anesthesiology residency training program for dentists of two or more years duration, in accord with Commission on Dental Accreditation's Standards for Dental Anesthesiology Residency Programs, and/or meets the eligibility requirements for examination by the American Dental Board of Anesthesiology. DR. Phong Cam Ta, D.D.S. NPI is 1861646747. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

410 W 53RD ST
APT 126
NEW YORK, NY
ZIP 10019-622
Phone: (215) 527-8768

The NPI 1861646747 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 11/5/2008 and was last updated on 6/16/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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