Healthcare Provider Details

I. General information

NPI: 1871755389
Provider Name (Legal Business Name): CLAIRE C PAIK D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2008
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2860 S GREEN BAY RD STE 104
MT PLEASANT WI
53406-4962
US

IV. Provider business mailing address

2860 S GREEN BAY RD STE 104
MT PLEASANT WI
53406-4962
US

V. Phone/Fax

Practice location:
  • Phone: 262-886-9700
  • Fax:
Mailing address:
  • Phone: 262-886-9700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number6002125-15
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: