Michele Laux Pavlisin, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

59950 Issued in CA

Practice address

601 E Foothill Blvd
Claremont, CA 91711-3512

Phone

(909) 625-4101

NPI assigned

Dec 28, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644451200000",
    "number": "1902962848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 E FOOTHILL BLVD",
            "city": "CLAREMONT",
            "state": "CA",
            "postal_code": "917113512",
            "telephone_number": "909-625-4101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 E FOOTHILL BLVD",
            "city": "CLAREMONT",
            "state": "CA",
            "postal_code": "917113512",
            "telephone_number": "909-625-4101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAVLISIN",
        "first_name": "MICHELE",
        "middle_name": "LAUX",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-28",
        "last_updated": "2022-02-10",
        "certification_date": "2022-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019-019192",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "59950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine Patel, PHARMD
• Krutav Patel, DDS
• Manisha Patel, PA-C
• Irfana Patla
• Paul D.Orr, M.D., Inc.
• Jillian Alexis Peace-Redd, LMFT
• Pediatric Care Services, Inc
• Samantha Rae Peebles, RDN
• Adrian Pelaez, D.D.S.
• John Pellitteri, PSY.D.

• General Practice Dentistry in Claremont, CA
• Providers in Claremont, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.