Irene Thammasithiboon, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

25969 Issued in TX

Practice address

713 N Main St
Fort Stockton, TX 79735

Phone

(432) 336-6466

Fax

(432) 336-8248

NPI assigned

Mar 3, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Boon Dental Alliance P.a.

  • Prosthodontics
  • Fort Stockton, TX
  • NPI 1306065693
  NPD (past)

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

{
    "created_epoch": "1299110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334016000000",
    "number": "1447558150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "713 N. MAIN ST.",
            "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 ST",
            "city": "FORT STOCKTON",
            "state": "TX",
            "postal_code": "79735",
            "telephone_number": "432-336-6466",
            "fax_number": "432-336-8248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THAMMASITHIBOON",
        "first_name": "IRENE",
        "name_prefix": "Ms.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-03-03",
        "last_updated": "2012-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "0025969",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "25969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stockton Vitality, LLC
• Subodh K Mallik MD PA
• Subodh K Mallik, MD, PA
• Rosalie M Sullivan, FAMILY NURSE PRACTIT
• Sheri Jo Talley, M.D
• Prasert Thammasithiboon, MD
• Prasith Thammasithiboon, D.M.D.
• Trans-Pecos Imaging, Inc.
• Kaleb Kristiano Valenzuela, OD
• Auden C Velasquez, M.D.

• General Practice Dentistry in Fort Stockton, TX
• Providers in Fort Stockton, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 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.