Provider Demographics
NPI:1679784136
Name:MICHAEL E TAI DDS INC
Entity Type:Organization
Organization Name:MICHAEL E TAI DDS INC
Other - Org Name:VALLEY OAK DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:EUWEI
Authorized Official - Last Name:TAI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:408-842-9999
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:
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:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-25
Last Update Date:2012-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA49221122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty