Provider Demographics
NPI:1174367155
Name:PEREZ TROISI, CLAUDIA ANTONIETA
Entity type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:ANTONIETA
Last Name:PEREZ TROISI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21205 BOUNDARY RD
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:VA
Mailing Address - Zip Code:23314-4311
Mailing Address - Country:US
Mailing Address - Phone:757-404-8912
Mailing Address - Fax:
Practice Address - Street 1:1354 KEMPSVILLE RD STE 101
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-1416
Practice Address - Country:US
Practice Address - Phone:757-548-1611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-24
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401419019122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist