Provider Demographics
NPI:1912899501
Name:PHANRUNGSUWAN, AONJITTRA (DDS, PHD)
Entity type:Individual
Prefix:DR
First Name:AONJITTRA
Middle Name:
Last Name:PHANRUNGSUWAN
Suffix:
Gender:F
Credentials:DDS, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7892 KNIGHT RD APT 3010
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-3094
Mailing Address - Country:US
Mailing Address - Phone:614-680-9323
Mailing Address - Fax:
Practice Address - Street 1:7500 CAMBRIDGE ST # 6479
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-2032
Practice Address - Country:US
Practice Address - Phone:713-486-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-17
Last Update Date:2025-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXETN12021223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics