Active NPI
Thitaya Chaiboonyarak
- Student in an Organized Health Care Education/Training Program
- Boston, MA
National Provider Identifier
1003784810
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- License
- DL101029
- Practice address
- 100 E Newton St
Boston, MA 02118-3552 - Phone
- (617) 358-8300
- NPI assigned
- Oct 24, 2025
- Sex
- Unspecified or another gender identity
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DL101029 | MA | |
| Student in an Organized Health Care Education/Training Program | 390200000X | DL101029 | MA | Primary |
Addresses
Primary practice location
100 E Newton St
Boston, MA 02118-3552
Mailing address
405 Beacon St Apt 8
Boston, MA 02115-1134
Phone (617) 358-8300
Other practice location 1
7000 Great Meadow Rd
Dedham, MA 02026-4090
Phone (781) 234-9700
Other practice location 2
1200 Centre St
Roslindale, MA 02131-1000
Phone (617) 363-8000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DL101029 | MA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1761264000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1761264000000",
"number": "1003784810",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "405 BEACON ST APT 8",
"city": "BOSTON",
"state": "MA",
"postal_code": "021151134",
"telephone_number": "617-358-8300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 E NEWTON ST",
"city": "BOSTON",
"state": "MA",
"postal_code": "021183552",
"telephone_number": "617-358-8300"
}
],
"practiceLocations": [
{
"address_1": "7000 Great Meadow Rd",
"address_purpose": "LOCATION",
"city": "Dedham",
"state": "MA",
"postal_code": "020264090",
"country_code": "US",
"telephone_number": "781-234-9700",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1200 Centre St",
"address_purpose": "LOCATION",
"city": "Roslindale",
"state": "MA",
"postal_code": "021311000",
"country_code": "US",
"telephone_number": "617-363-8000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CHAIBOONYARAK",
"first_name": "THITAYA",
"sole_proprietor": "NO",
"sex": "X",
"enumeration_date": "2025-10-24",
"last_updated": "2025-10-24",
"certification_date": "2025-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MA",
"license": "DL101029",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "MA",
"license": "DL101029",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.