Individual provider Active NPI

Nongporn Kobkoowitaya, D.D.S.

  • General Practice Dentistry
  • Springfield, TN
National Provider Identifier
1366516510
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS7467 Issued in TN
Practice address
2701 Memorial Blvd
Springfield, TN 37172-4238
Phone
(615) 384-2099
Fax
(615) 384-7732
NPI assigned
Nov 20, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DS7467 TN Primary

Addresses

Primary practice location

2701 Memorial Blvd
Springfield, TN 37172-4238

Mailing address

2701 Memorial Blvd
Springfield, TN 37172-4238
Phone (615) 384-2099

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

LicenseStateTypeSpecialty
DS7467TNMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Harmony Smile Dental PLLC General Practice PastSince Oct 8, 2023 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366516510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 MEMORIAL BLVD",
            "city": "SPRINGFIELD",
            "state": "TN",
            "postal_code": "371724238",
            "telephone_number": "615-384-2099",
            "fax_number": "615-384-7732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 MEMORIAL BLVD",
            "city": "SPRINGFIELD",
            "state": "TN",
            "postal_code": "371724238",
            "telephone_number": "615-384-2099",
            "fax_number": "615-384-7732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOBKOOWITAYA",
        "first_name": "NONGPORN",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "DS7467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.