Provider Demographics
NPI:1770714578
Name:CHOKSHI, PAYAL P (DMD)
Entity type:Individual
Prefix:
First Name:PAYAL
Middle Name:P
Last Name:CHOKSHI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:759 PARKWAY STREET
Mailing Address - Street 2:SUITE# 103
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33477
Mailing Address - Country:US
Mailing Address - Phone:561-744-3646
Mailing Address - Fax:561-748-5123
Practice Address - Street 1:759 PARKWAY STREET
Practice Address - Street 2:SUITE# 103
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33477
Practice Address - Country:US
Practice Address - Phone:561-744-3646
Practice Address - Fax:561-748-5123
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-29
Last Update Date:2012-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN18713122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist