Individual provider Active NPI

Hattapol Kumchai

  • Prosthodontics
  • Boston, MA
National Provider Identifier
1679167464
Registry record updated Feb 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
DL14691 Issued in MA
Practice address
1 Kneeland St
Boston, MA 02111-1527
Phone
(617) 834-7210
NPI assigned
Feb 23, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ProsthodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0700X DL14691 MA Primary

Addresses

Primary practice location

1 Kneeland St
Boston, MA 02111-1527

Mailing address

665 Washington St PH 26a
Boston, MA 02111-1658
Phone (617) 834-7210

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Hattapol.kumchai@tufts.edu Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DL14691MAMDProsthodontist

NPI Registry JSON

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

{
    "created_epoch": "1614038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614038400000",
    "number": "1679167464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "665 WASHINGTON ST PH 26A",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111658",
            "telephone_number": "617-834-7210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 KNEELAND ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111527",
            "telephone_number": "617-834-7210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUMCHAI",
        "first_name": "HATTAPOL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-02-23",
        "last_updated": "2021-02-23",
        "certification_date": "2021-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Prosthodontics",
            "state": "MA",
            "license": "DL14691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Hattapol.kumchai@tufts.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1 Kneeland St",
            "city": "Boston",
            "state": "MA",
            "country_code": "US",
            "postal_code": "021111527",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2021; 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.