Supakit

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

21159 Issued in TX

Legal business name

SUPAKIT

Practice address

6300 Harry Hines Blvd
Suite 600
Dallas, TX 75235-5259

Phone

(214) 456-8825

Fax

(214) 456-8256

NPI assigned

Aug 30, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Supakit Peanchitlertkajorn, DDS, MDSNPI 1033228978

Title

Owner

Phone

(214) 456-8825

Specialties & licenses 1

Addresses

Practitioners 1

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

• Supakit Peanchitlertkajorn, D.D.S., MDS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Dallas, TX
  • NPI 1033228978
  NPD (past) Authorized official

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1376652248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35408",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752350408",
            "telephone_number": "214-456-8825",
            "fax_number": "214-456-8256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6300 HARRY HINES BLVD",
            "address_2": "SUITE 600",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752355259",
            "telephone_number": "214-456-8825",
            "fax_number": "214-456-8256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPAKIT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PEANCHITLERTKAJORN",
        "authorized_official_first_name": "SUPAKIT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "214-456-8825",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, MDS"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "TX",
            "license": "21159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Orthodontics and Dentofacial Orthopedics Dentistry in Dallas, TX
• Providers in Dallas, TX by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.