Thasanai Roongruangphol, D.D.S., M.S.

Primary specialty

DentistTaxonomy code 122300000X

License

60265 Issued in CA

Practice address

349 Amds
Travis Afb, CA 94535

Phone

(707) 424-3812

NPI assigned

Oct 24, 2006

Sex

Male

Sole proprietor

No

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

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602460800000",
    "number": "1487738605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4028 LAMBERT RD",
            "city": "EL SOBRANTE",
            "state": "CA",
            "postal_code": "948031710",
            "telephone_number": "682-201-5521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "349 AMDS",
            "city": "TRAVIS AFB",
            "state": "CA",
            "postal_code": "94535",
            "telephone_number": "707-424-3812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROONGRUANGPHOL",
        "first_name": "THASANAI",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2020-10-12",
        "certification_date": "2020-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "TX",
            "license": "22823",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "60265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danelle Roddy, MS
• Edward Sean Rodriguez, I.D.M.T
• Timothy Rohlfing, IDMT
• Nathan Rojas
• Joshua Romain, M.D.
• Rodney Ray Rosfeld, PHARM.D.
• Michael Ross
• Thomas Ross, CRNA
• David Michael Rosso, M.D.
• David Rothas, D.D.S.

• Dentist in Travis Afb, CA
• Providers in Travis Afb, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 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.