Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Ethan Thien Ta, DMD

Individual provider Dentist · NPI 1376432302

Ethan Thien Ta, DMD is a Dentist in Camp Pendleton, California. Licensed in California. Registered with an NPI since 2025.

Licensed in
CA
In the registry since
2025
What do these letters mean?
DMD — Doctor of Dental Medicine
A dentist. Identical training and licensing to a DDS.

See every abbreviation used in this directory →

Practice location Address checks out

200 Mercy Cir
Camp Pendleton, CA 92055
Phone: (760) 725-5870
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence 111703 (CA)

Record details

NPI number1376432302
Entity typeIndividual (Type 1)
GenderMale
Credentials DMD
Sole proprietorNo
NPI enumeratedJuly 2, 2025
Last updated in NPPESJuly 2, 2025
Certification dateJune 17, 2025
Mailing address4128 Rio Azul Way, Oceanside, CA 92057-3554

Other providers in Camp Pendleton