SUPONTEP TEERAKANOK
Dentist (Periodontics)

Address: Henry Goldman School of Dental Medicine, 635 Albany St, Boston, MA 02118

SUPONTEP TEERAKANOK (NPI# 1871134833) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1871134833
Entity Type Individual
Full Name DR. SUPONTEP TEERAKANOK
Gender Male
Credential DDS
Practice Address Henry Goldman School of Dental Medicine
635 Albany St
Boston
MA 02118
Practice Telephone 6177637550
Mailing Address 18 Elba St
Brookline
MA 02446-6759
Mailing Telephone 6177637550
Enumeration Date 2019-10-01
Last Update Date 2019-10-01
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification Taxonomy Group License Number License State Taxonomy Group
Y 1223P0300X Dentist
Specialization: Periodontics
DL14138 MA Dental Providers

Office Location

Street Address HENRY GOLDMAN SCHOOL OF DENTAL MEDICINE
635 ALBANY ST
City BOSTON
State MA
Zip Code 02118

Providers in the same zip code prefix

NPI Name Taxonomy Address Enumeration
1992396477 Lisa R Lee Counselor Bay Cove Ucc, 85 E Newton Street, Boston, MA 02118 2021-01-28
1649870023 Carlos E Salazar Counselor · Addiction (Substance Use Disorder) Hcrc 23 Bradston St., Boston, MA 02118 2020-10-27
1780292607 Jinal Gandhi Student in an Organized Health Care Education/Training Program Shapiro Primary Care, 725 Albany Street, Boston, MA 02118 2020-07-16
1669094777 German Eduardo Velez Student in an Organized Health Care Education/Training Program One Boston Medical Center Place Boston Medical Center, Boston, MA 02118 2020-05-12
1255969895 Isabela Medeiros Heringer Pereira Student in an Organized Health Care Education/Training Program 670 Albany Stree, 4th Floor, Boston, MA 02118 2020-03-30
1033746466 Karan Sunil Hingorani Student in an Organized Health Care Education/Training Program Shapiro Primary Care, 725 Albany Street, Precepting Room, Boston, MA 02118 2020-03-25
1326672791 Azza Ahmed Dentist · Pediatric Dentistry 635 Albany St. G-744, Boston, MA 02118 2020-02-25
1538707401 Jane Margolis Social Worker · Clinical 840 Harrison Ave., Dowling 2 South, Boston, MA 02118 2019-12-11
1750939583 Qasim Silman Ajmi Orthopaedic Surgery Department of Orthopaedic Surgery Boston Medical Center, 850 Harrison Ave Dowling 2 North, Boston, MA 02118 2019-08-26
1922655539 Jami Ryan Pollard Physician Assistant 840 Harrison Avenue, Menino Building, Boston, MA 02118 2019-08-20
Find all providers in zip 02118

Taxonomy Information

Taxonomy Code 1223P0300X
Grouping Dental Providers
Classification Dentist
Specialization Periodontics

Taxonomy Definition

That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.
Notes: Source: Council on Dental Education and Licensure, American Dental Association

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1437700218 Mansour Alasiri 650 Albany St Ste 341, Boston, MA 02118-2518 2019-09-24
1508417338 Bushra Aljahdali 650 Albany St Fl 3, Boston, MA 02118-2518 2019-09-23
1043863533 Ricardo Lazaro Pascual 1 Kneeland St Dept, Boston, MA 02111-1527 2019-07-23
1992294979 Smile Design Boston · Smile Design Boston 21 Custom House St Ste 110, Boston, MA 02110-3525 2018-05-06
1245739291 Maryam A Alsendi 100 E Newton St Ste G217, Boston, MA 02118-2308 2018-02-05
1528590783 Rayan Al Edreesi 100 E Netwton St, Suite G-217, Boston, MA 02118 2017-03-28
1013457290 Majed Khalid M Alshehri 100 East Newton Street Boston, Boston, MA 02118 2017-03-07
1699105734 Perico Back Bay, LLC 400 Commonwealth Ave. 3rd Flr., Boston, MA 02215 2013-11-26
1639429525 Majdi Ahmed Aladmawy 1 Kneeland St, Dhs 15, Boston, MA 02111 2012-09-18
1467702373 Zuhair Natto One Kneeland St, Dhs 15th Floor, Boston, MA 02111 2012-09-18
Find all providers in BOSTON

Competitor

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City BOSTON
Zip Code 02118

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NPI Name Taxonomy Address Enumeration
1174906002 Jirapat Teerakanok Student in an Organized Health Care Education/Training Program 119 Belmont Street, Rheumatology, Worcester, MA 01605 2015-07-09

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.