Provider Demographics
NPI:1508990771
Name:TAI, EUWEI MICHAEL (DDS)
Entity Type:Individual
Prefix:DR
First Name:EUWEI
Middle Name:MICHAEL
Last Name:TAI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:MICHAEL
Other - Middle Name:EUWEI
Other - Last Name:TAI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:7845 MONTEREY ST
Mailing Address - Street 2:
Mailing Address - City:GILROY
Mailing Address - State:CA
Mailing Address - Zip Code:95020-4519
Mailing Address - Country:US
Mailing Address - Phone:408-842-9999
Mailing Address - Fax:408-842-2821
Practice Address - Street 1:7845 MONTEREY ST
Practice Address - Street 2:
Practice Address - City:GILROY
Practice Address - State:CA
Practice Address - Zip Code:95020-4519
Practice Address - Country:US
Practice Address - Phone:408-842-9999
Practice Address - Fax:408-842-2821
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA492211223D0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1223D0001XDental ProvidersDentistDental Public Health
Not Answered122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA49221OtherLISENSE NUMBER