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NPI Code Detail

MEDICARE: PEARL32 FAMILY DENTISTRY LLC

MEDICARE: PEARL32 FAMILY DENTISTRY LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QD0000XDental Clinic/Center

General Provider Information

NPI Number : 1144098658
Entity Type Code : Organization
Provider Name (Legal Business Name) : PEARL32 FAMILY DENTISTRY LLC
Provider Business Mailing Address
First Line : 1032 S SPRING ST
Second Line :
City : PORT WASHINGTON
State : WI
Zip : 53074-2455
Country : US
Telephone Number : 262-284-5788
Fax Number :
Provider Business Practice Location Address
First Line : 1032 S SPRING ST
Second Line :
City : PORT WASHINGTON
State : WI
Zip : 53074-2455
Country : US
Telephone Number : 262-284-5788
Fax Number :
Authorized Official
Title or Position : OWNER DENTIST
Name : VIRATI CHOKSHI
Credential : DDS
Telephone Number : 262-284-5788
Provider Enumeration Date : 12/13/2023
Last Update Date : 03/10/2025

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Directions to “PEARL32 FAMILY DENTISTRY LLC ” Practice Location

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