NPIMap

Organization Active NPI

Boon Dental Alliance P.a.

  • Prosthodontics
  • Fort Stockton, TX
National Provider Identifier
1306065693
Registry record updated Mar 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
Legal business name
BOON DENTAL ALLIANCE P.A.
Practice address
713 N. Main
Fort Stockton, TX 79735
Phone
(432) 336-6466
Fax
(432) 336-8248
NPI assigned
Apr 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Prasith R Thammasithiboon, DMDNPI 1396964680
Title
Owner
Phone
(469) 733-8183

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ProsthodonticsGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223P0700X Primary

Addresses

Primary practice location

713 N. Main
Fort Stockton, TX 79735

Mailing address

713 N. Main
Fort Stockton, TX 79735
Phone (432) 336-6466

National Provider Directory

National Provider Directory

Locations

713 N Main St
Fort Stockton, TX 79735
Phone (432) 336-6466

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330560000000",
    "number": "1306065693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "713 N. MAIN",
            "city": "FORT STOCKTON",
            "state": "TX",
            "postal_code": "79735",
            "telephone_number": "432-336-6466",
            "fax_number": "432-336-8248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "713 N. MAIN",
            "city": "FORT STOCKTON",
            "state": "TX",
            "postal_code": "79735",
            "telephone_number": "432-336-6466",
            "fax_number": "432-336-8248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOON DENTAL ALLIANCE P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-24",
        "last_updated": "2012-03-01",
        "status": "A",
        "authorized_official_last_name": "THAMMASITHIBOON",
        "authorized_official_first_name": "PRASITH",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "469-733-8183",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Prosthodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Stockton, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.