Norachai Phisuthikul, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

22DI02345400 Issued in NJ

Practice address

110 Bergen St
Room C781
Newark, NJ 07103-2495

Phone

(973) 972-4210

NPI assigned

Aug 13, 2009

Last updated

Aug 13, 2009By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Focus Dental Specialists

  dba Prestige Dental Specialists

  • Periodontics
  • Annandale, VA
  • NPI 1174118723
  NPD Authorized official

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

{
    "created_epoch": "1250121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1250121600000",
    "number": "1568694222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 ROYAL COURT DR APT J20",
            "city": "SPRING LAKE",
            "state": "NJ",
            "postal_code": "077622324",
            "telephone_number": "646-246-1978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 BERGEN ST",
            "address_2": "ROOM C781",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071032495",
            "telephone_number": "973-972-4210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHISUTHIKUL",
        "first_name": "NORACHAI",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-08-13",
        "last_updated": "2009-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI02345400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keith Phillips
• Laura N Phillips, PT
• Mirandah Phillips, LCSW
• Philosophos Counseling
• Nicole Phin
• Physicians Dialysis Inc (Newark Dialysis Center)
• Justin J. Pi, M.D.
• Ernest Debrah Pianim, PHARMD
• Maria Vieira Picciano, M.D.
• Robert Picciano, M.D.

• Dentist in Newark, NJ
• Providers in Newark, NJ by specialty
• Dentist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2009; 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.