Kittima Boonsirisermsook, D.D.S.

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

052803-1 Issued in NY

Practice address

Naval Medical Center Portsmouth
620 John Paul Jones Circle
Portsmouth, VA 23708

Phone

(757) 953-8329

NPI assigned

Aug 29, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670544000000",
    "number": "1427166206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "NAVAL MEDICAL CENTER PORTSMOUTH",
            "address_2": "620 JOHN PAUL JONES CIRCLE",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "23708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "NAVAL MEDICAL CENTER PORTSMOUTH",
            "address_2": "620 JOHN PAUL JONES CIRCLE",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "23708",
            "telephone_number": "757-953-8329"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8901 Wisconsin Ave",
            "address_purpose": "LOCATION",
            "city": "Bethesda",
            "state": "MD",
            "postal_code": "208890001",
            "country_code": "US",
            "telephone_number": "301-295-0145",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOONSIRISERMSOOK",
        "first_name": "KITTIMA",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-29",
        "last_updated": "2022-12-09",
        "certification_date": "2022-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "NY",
            "license": "052803-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kittima.b.morton.mil@health.mil",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "Naval Medical Center Portsmouth",
            "address_2": "620 John Paul Jones Circle",
            "city": "Portsmouth",
            "state": "VA",
            "country_code": "US",
            "postal_code": "23455",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ashley Boone
• Devona Natalie Boone
• Jamylah Brene Boone, CERTIFIED DOULA
• Lovetta S Boone
• Paula Harmon Boone, OD
• Gregory Booth
• Rachel Marie Boots, DO, MPH
• Eric Joseph Bopp, RN
• Roderick Craig Borgie, M.D.
• Mia Borte

• Endodontics in Portsmouth, VA
• Providers in Portsmouth, VA by specialty
• Endodontics in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.