Wirawut Thothong Semtner, DMD

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

141 Issued in OK

Practice address

404 S Elm St Ste 108
Jenks, OK 74037-3714

Phone

(918) 417-2417

NPI assigned

Feb 16, 2021

Last updated

Mar 14, 2024By 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 3

Addresses

Other names 1

• Wirawut Thothong Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1613433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710374400000",
    "number": "1922691328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 S ELM ST STE 108",
            "city": "JENKS",
            "state": "OK",
            "postal_code": "740373714",
            "telephone_number": "918-417-2417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 S ELM ST STE 108",
            "city": "JENKS",
            "state": "OK",
            "postal_code": "740373714",
            "telephone_number": "918-417-2417"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "839 W Congress St",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857452819",
            "country_code": "US",
            "telephone_number": "972-639-6313",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SEMTNER",
        "first_name": "WIRAWUT",
        "middle_name": "THOTHONG",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-02-16",
        "last_updated": "2024-03-14",
        "certification_date": "2024-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OK",
            "license": "7688",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN26105",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "OK",
            "license": "141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WIRAWUT",
            "last_name": "THOTHONG",
            "credential": "BS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Pediatric Dentistry in Jenks, OK
• Providers in Jenks, OK by specialty
• Pediatric Dentistry in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2024; 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.