Jaisanvi PA

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

JAISANVI PA

Doing business as

Riverwalk Dental Group

Practice address

308 NW Bethany Dr
Port St Lucie, FL 34986-3578

Phone

(772) 247-6750

Fax

(561) 250-8292

NPI assigned

Jun 17, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Payal Chokshi, DMD

Title

Owner

Phone

(561) 703-0219

Specialties & licenses 1

Addresses

Other names 1

• Riverwalk Dental Group Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1560729600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1608076800000",
    "number": "1174183719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 NW BETHANY DR",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349863578",
            "telephone_number": "561-744-3646",
            "fax_number": "561-748-5123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 NW BETHANY DR",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349863578",
            "telephone_number": "772-247-6750",
            "fax_number": "561-250-8292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAISANVI PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-17",
        "last_updated": "2020-12-16",
        "certification_date": "2020-12-16",
        "status": "A",
        "authorized_official_last_name": "CHOKSHI",
        "authorized_official_first_name": "PAYAL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "561-703-0219",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Riverwalk Dental Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Riverwalk Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Vilna D Jacob
• Brian Bernard Jacobus, DDS, MS, PA
• Nancy Jacques
• Rebecca Jacques, RN
• Jaime Toro MD PA
• Sediah Jaleiba, PTA,CLT
• Jamaica Shores Assisted Living Facility
• James L. Autin, M.D.,P.a.
• James M Melotek MD PA
• Carol James

• Dental Clinic/Center in Port St Lucie, FL
• Providers in Port St Lucie, FL by specialty
• Dental Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.