Provider Demographics
NPI:1265863203
Name:DESAI, MEGHA NIRAV (DDS)
Entity Type:Individual
Prefix:DR
First Name:MEGHA
Middle Name:NIRAV
Last Name:DESAI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:184 MARY CT
Mailing Address - Street 2:
Mailing Address - City:BRIDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:08807-5652
Mailing Address - Country:US
Mailing Address - Phone:201-675-3936
Mailing Address - Fax:
Practice Address - Street 1:184 MARY CT
Practice Address - Street 2:
Practice Address - City:BRIDGEWATER
Practice Address - State:NJ
Practice Address - Zip Code:08807-5652
Practice Address - Country:US
Practice Address - Phone:201-675-3936
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-02
Last Update Date:2013-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI02554700122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist