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TEERARAT NEAL PHUATRAKOON
NPI 1194619155
Dentist - Periodontics in Roseville, CA

Active since June 04, 2025
1623 SANTA CLARA DR STE 100, ROSEVILLE, CA 95661(916) 788-1114 Get Directions Write a Review

NPPES record last updated: November 24, 2025. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Nov 24, 2025, Jun 4, 2025 (2 updates tracked since 2025).

About Teerarat Neal Phuatrakoon NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TEERARAT NEAL PHUATRAKOON (NPI 1194619155) is an individual periodontics provider in Roseville, California, licensed in California (DDS107567) and active in the NPI registry since June 2025.

NPPES Registry Identity

NPI1194619155
Entity TypeIndividualMale
Primary Taxonomy1223P0300X
Provider Legal NameTEERARAT NEAL PHUATRAKOON
Location Address1623 SANTA CLARA DR STE 100Roseville, CA 95661-3589
Mailing AddressPo Box 1266Rancho Cucamonga, CA 91729-1266
Phone(916) 788-1114
Sole ProprietorNo
Enumeration DateJune 4, 2025
Last NPPES UpdateNovember 24, 20252 updates tracked since enumeration
NPPES CertifiedNovember 24, 2025
✔ NPI 1194619155 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · PeriodonticsDental Providers
Taxonomy Code1223P0300X
License✔ Licensed in CA · DDS107567
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.
1623 SANTA CLARA DR STE 100, Roseville, CA 95661
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Humana.Insurance ›

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KRISTEN YOUNG DDS, MS, INC.
Dentist (Periodontics)
1623 SANTA CLARA DR STE 100
ROSEVILLE, CA 95661
Placer County (650) 455-7912
TU LE
Dentist (Periodontics)
1623 SANTA CLARA DR STE 100
ROSEVILLE, CA 95661
Placer County (424) 413-1939

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Teerarat Phuatrakoon's NPI number?

The NPI number for Teerarat Phuatrakoon is 1194619155. It was assigned to this individual provider in the NPPES registry on June 4, 2025.

Where is Teerarat Phuatrakoon located?

Teerarat Phuatrakoon practices at 1623 Santa Clara Dr Ste 100, Roseville, CA 95661. The listed phone number is (916) 788-1114.

What is Teerarat Phuatrakoon's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Periodontics, with taxonomy code 1223P0300X.

What insurance does Teerarat Phuatrakoon accept?

Health plans from Anthem Blue Cross and Blue Shield and Humana list Teerarat Phuatrakoon as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Teerarat Phuatrakoon was last updated on November 24, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.