Thasanavadee Phromchotikul, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D7390 Issued in OR

Practice address

7417 SW Beaverton Hillsdale Hwy
#600
Portland, OR 97225-2169

Phone

(503) 203-1311

Fax

(503) 203-6889

NPI assigned

Oct 5, 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

Other names 1

• Thas Phromchotikul Other name

Medicare fee-for-service enrollment

Enrolled in OR

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

Interoperability endpoints

• Direct secure messaging: tphromchotikul5767@direct.ochin.org

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396310400000",
    "number": "1457447369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7417 SW BEAVERTON HILLSDALE HWY",
            "address_2": "#600",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972252169",
            "telephone_number": "503-203-1311",
            "fax_number": "503-203-6889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7417 SW BEAVERTON HILLSDALE HWY",
            "address_2": "#600",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972252169",
            "telephone_number": "503-203-1311",
            "fax_number": "503-203-6889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHROMCHOTIKUL",
        "first_name": "THASANAVADEE",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2014-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D7390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "THAS",
            "last_name": "PHROMCHOTIKUL",
            "credential": "D.M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• General Practice Dentistry in Portland, OR
• Providers in Portland, OR by specialty
• General Practice Dentistry in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2014; 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.