Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Phennatda Polpornvitoon

Individual provider Dentist · NPI 1568082030

Phennatda Polpornvitoon is a Dentist in Port Charlotte, Florida. Works from 2 locations. Licensed in Florida.

Licensed in
FL
In the registry since
2020
Specialties on file
2
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Practice location Address checks out

18000 Toledo Blade Blvd
Port Charlotte, FL 33948-1980
Phone: (941) 740-8598
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 801 S Paulina St Rm 110, Chicago, IL 60612-7210 — (312) 996-1052

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X · Licence DN25388 (FL)
Dentist Taxonomy 122300000X · Licence DN25388 (FL)

Record details

NPI number1568082030
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedApril 24, 2020
Last updated in NPPESJune 10, 2022
Certification dateJune 10, 2022
Mailing address18000 Toledo Blade Blvd, Port Charlotte, FL 33948-1980

Other providers in Port Charlotte