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

Individual provider Dentist · NPI 1417823501

Watchariyaporn Thasai is a Dentist in Chicago, Illinois. Practices as a sole proprietor. Licensed in Illinois.

Licensed in
IL
In the registry since
2025
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Practice location Address checks out

4901 N Kedzie Ave
Chicago, IL 60625-5009
Phone: (773) 895-9202
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence 019035849 (IL)

Record details

NPI number1417823501
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedOctober 15, 2025
Last updated in NPPESDecember 8, 2025
Certification dateDecember 8, 2025

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