Ethan Thien Ta is a Camp Pendleton, California based Dentist who is specialized in
Dentistry. He does not accept the Medicare-approved amount. Patients will be billed for the treatment. Active license number of Ethan Thien Ta is
111703 for Dentistry in California. His current practice location is
200 Mercy Circle, Camp Pendleton. Patients can reach him at
760-725-5870.
Ethan Thien Ta is the primary dental care provider for patients of all ages. He is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
Complete Profile:
Ethan Thien Ta speciality, credentials, practice address, contact phone number and fax are as below.
Patients can directly walk in or can call on the below given phone number for appointment.
| Name: | Ethan Thien Ta |
| Specialization: | Dentist |
| Gender: | Male |
| Credentials: | DMD |
| Accepts Medicare Assignment: | No |
| Practice Address: | 200 Mercy Circle, Camp Pendleton,
California, 92055 |
| Phone: | 760-725-5870 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
| NPI Number: | 1376432302 |
| NPI Enumeration Date: | 02 Jul, 2025 |
| NPI Last Update On: | 02 Jul, 2025 |
Medical Licenses:
Doctors can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Ethan Thien Ta are as mentioned below.
| License Number | Specialization | State | Status | |
| 111703 | Dentistry | California | Primary | |
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | 4128 Rio Azul Way,
Oceanside, California |
| Zip: | 92057-3554 |
| Phone Number: | 952-649-1301 |
Patients can reach Ethan Thien Ta at
200 Mercy Circle, Camp Pendleton, California or can
call to book an appointment on 760-725-5870.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on
08 December, 2025.