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

Michelle Ta, DMD

Individual provider Pediatric Dentistry · NPI 1124643739

Michelle Ta, DMD is a Pediatric Dentistry in San Rafael, California. Licensed in California. Registered with an NPI since 2020.

Licensed in
CA
In the registry since
2020
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

912 Grand Ave Ste 202
San Rafael, CA 94901-3552
Phone: (408) 717-0888
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Dentistry (primary) Taxonomy 1223P0221X · Licence DDS104671 (CA)

Record details

NPI number1124643739
Entity typeIndividual (Type 1)
GenderFemale
Credentials DMD
Sole proprietorNo
NPI enumeratedJune 9, 2020
Last updated in NPPESJune 9, 2020
Certification dateJune 9, 2020
Mailing address77 Tennant Ave, San Jose, CA 95138-1851

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