Kiatkachorn Ratanatharathorn, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

102782 Issued in CA

Practice address

2420 S Azusa Ave
West Covina, CA 91792-1512

Phone

(626) 810-2691

NPI assigned

Jul 16, 2018

Sex

Male

Sole proprietor

No

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

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Kiatkachorn Ratanatharathorn, DDS Inc

  • Dental Clinic/Center
  • West Covina, CA
  • NPI 1891402079
  NPD Authorized official
• Chun Yao Liao Dental Corporation

  • General Practice Dentistry
  • West Covina, CA
  • NPI 1043613953
  NPD (past)

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

{
    "created_epoch": "1531699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677542400000",
    "number": "1750867487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2420 S AZUSA AVE",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917921512",
            "telephone_number": "626-810-2691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2420 S AZUSA AVE",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917921512",
            "telephone_number": "626-810-2691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RATANATHARATHORN",
        "first_name": "KIATKACHORN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-16",
        "last_updated": "2023-02-28",
        "certification_date": "2023-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "102782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joshua Garzon Ramos, RPH
• Ramtin Khaef DMD Inc
• Ramzi Dental Corporation
• Jasmine Ransom
• Amanda Michelle Rapinchuk
• Dana Linnea Rawlings, O.D.
• Priynka Rawtani
• Raymundo S. Bautista M.D. Apc
• Mireya Eunice Recinos
• Lindsay Edna Reeder-Mendoza

• Dentist in West Covina, CA
• Providers in West Covina, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2023; 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.