Individual provider Active NPI

Vishakha Ravindra Choudhari

  • Dentist
  • Milwaukee, WI
National Provider Identifier
1801639661
Registry record updated Jun 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
6001581-15 Issued in WI
Practice address
5341 W Fond Du Lac Ave
Milwaukee, WI 53216-1365
Phone
(414) 871-0827
NPI assigned
Jun 18, 2024
Last updated
Jun 18, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 6001581-15 WI Primary

Addresses

Primary practice location

5341 W Fond Du Lac Ave
Milwaukee, WI 53216-1365

Mailing address

2011 S Huron Pkwy Apt 7
Ann Arbor, MI 48104-4162
Phone (734) 680-3873

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6001581-15WIMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Familia Dental Mke Midtown LLC CurrentSince Jun 23, 2024 Accepting new patients

Locations

5341 W Fond du Lac Ave
Milwaukee, WI 53216
Phone (414) 871-0827

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1718668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718668800000",
    "number": "1801639661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2011 S HURON PKWY APT 7",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481044162",
            "telephone_number": "734-680-3873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5341 W FOND DU LAC AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532161365",
            "telephone_number": "414-871-0827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHOUDHARI",
        "first_name": "VISHAKHA RAVINDRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-18",
        "last_updated": "2024-06-18",
        "certification_date": "2024-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "6001581-15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2024; 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.