Dr. Supontep Teerakanok
Dentist (Periodontics)

Address: Henry Goldman School of Dental Medicine, 635 Albany St, Boston, MA 02118
Phone: 6177637550

Dr. 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 Identifier (NPI) 1871134833
Entity Type Individual
Full Name Dr. Supontep Teerakanok
Credential DDS
Gender Male
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
Sole Proprietor No, this individual is not a Sole Proprietor
Enumeration Date 2019-10-01
Last Update Date 2019-10-01

Taxonomy Codes

Primary Taxonomy Classification Taxonomy Group License Number State
Yes 1223P0300X Dentist · Periodontics Dental Providers DL14138 MA

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

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

NPI Name Taxonomy Address Enumeration
1538707401 Jane Margolis Social Worker 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
1689220097 Rachel Lynne Maas Social Worker 85 East Newton Street, 8th Floor, Suite 802, Boston, MA 02118 2019-08-12
1003461849 Hisham Joseph Gharib Dentist Boston University Henry M. Goldman School of Dentistry, 635 Albany St, Boston, MA 02118 2019-08-08
1750936985 Manju Natarajan Dentist 635, Albany Street, Room No 306, Boston, MA 02118 2019-08-05
1346894136 Audrey Armelle Ndombou Case Manager/Care Coordinator 1640 Washington St Boston, Boston, MA 02118 2019-07-30
1346893336 Gregory Michael Cohen Student in an Organized Health Care Education/Training Program 720 Harrison Ave Boston Medical Center, Doctors Office, Suite 7600, Boston, MA 02118 2019-07-19
1568020352 Unknown Hemamalini Chandrashekhar Student in an Organized Health Care Education/Training Program 1 Boston Medical Center Place, Boston Medical Center, Boston, MA 02118 2019-06-05
1780241554 Neusa De Pina Case Manager/Care Coordinator 11640 Washinton Street, Boston, MA 02118 2019-05-28
1780145292 Fangnan Elisha Ndam Student in an Organized Health Care Education/Training Program 670 Albany Street 4th Floor, Department of Pathology and Laboratory Medicine, Boston, MA 02118 2019-03-27
Find all providers in zip 02118

Competitor

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City BOSTON
Zip Code 02118

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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.

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