MEDICARE: PRIYANKA CHOKSHI

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
1	390200000X	Student in an Organized Health Care Education/Training Program
2	1223G0001X	General Practice Dentistry	18258	MD

General Provider Information

NPI Number	:	1184300758
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PRIYANKA CHOKSHI

Provider Business Mailing Address
First Line	:	1051 ROLAND HEIGHTS AVE
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21211-1239
Country	:	US
Telephone Number	:	443-447-8996
Fax Number	:

Provider Business Practice Location Address
First Line	:	1051 ROLAND HEIGHTS AVE
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21211-1239
Country	:	US
Telephone Number	:	443-447-8996
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/27/2023
Last Update Date	:	07/31/2024

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Directions to “ PRIYANKA CHOKSHI ” Practice Location

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