Active NPI
Prachaya Charoenkitkarn, DMD
- Dentist
- Reading, MA
National Provider Identifier
1073297370
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN1859778
- Practice address
- 636 Main St
Reading, MA 01867-0062 - Phone
- (007) 278-1944
- NPI assigned
- Jun 15, 2023
- Last updated
- Jun 15, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DN1859778 | MA | Primary |
Addresses
Primary practice location
636 Main St
Reading, MA 01867-0062
Mailing address
50 Malden St Apt 222
Boston, MA 02118-2889
Phone (312) 874-9010
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 |
|---|---|---|---|
| DN1859778 | MA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1686787200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1686787200000",
"number": "1073297370",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "50 MALDEN ST APT 222",
"city": "BOSTON",
"state": "MA",
"postal_code": "021182889",
"telephone_number": "312-874-9010"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "636 MAIN ST",
"city": "READING",
"state": "MA",
"postal_code": "018670062",
"telephone_number": "007-278-1944"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAROENKITKARN",
"first_name": "PRACHAYA",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-06-15",
"last_updated": "2023-06-15",
"certification_date": "2023-05-28",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MA",
"license": "DN1859778",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Reading, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.