IndividualActive
Supontep Teerakanok, DDS
NPI 1871134833 · Periodontics · Boston, MA
Provider details
- NPI number
- 1871134833
- Entity type
- Individual
- Primary specialty
- PeriodonticsDental Providers
- Credential
- DDS
- Sex
- Male
- Sole proprietor
- No
- License
- DL14138 (MA)
Specialties & taxonomies
Dental Providers
Profile Score
Established profile(65/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
6 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Henry Goldman School of Dental Medicine
635 Albany St
Boston, MA 02118
Phone: (617) 763-7550
Approximate (ZIP-level) locationGet directions
Mailing address
18 Elba St
Brookline, MA 02446-6759
Registry dates
- Enumerated
- 2019-10-01
- Last updated
- 2019-10-01
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.