Celestino F Perez, D.D.S

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4635 Issued in WI

Practice address

1000 N Wisconsin St
Port Washington, WI 53074-1285

Phone

(262) 284-9767

Fax

(262) 284-5228

NPI assigned

Aug 19, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Port Dental Group SC

  • General Practice Dentistry
  • Port Washington, WI
  • NPI 1801913173
  NPD

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433116800000",
    "number": "1306950902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 N WISCONSIN ST",
            "city": "PORT WASHINGTON",
            "state": "WI",
            "postal_code": "530741285",
            "telephone_number": "262-284-9767",
            "fax_number": "262-284-5228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 N WISCONSIN ST",
            "city": "PORT WASHINGTON",
            "state": "WI",
            "postal_code": "530741285",
            "telephone_number": "262-284-9767",
            "fax_number": "262-284-5228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "CELESTINO",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-19",
        "last_updated": "2015-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "4635",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33723100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicole Anne Parulski, DPT
• Damien Payne
• Pearl32 Family Dentistry LLC
• Sherry L Peck, LPC, ATR
• Bonnie Louise Penkwitz, CERTIFIED NURSING AS
• Cheryl M Petersen, PT
• David Arthur Peterson, PT
• Linda Ann Phillips, OT
• Melissa Lu Pinke
• Susan Pokorny, CERTIFIED DOULA

• General Practice Dentistry in Port Washington, WI
• Providers in Port Washington, WI by specialty
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2015; 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.