Provider Demographics
NPI:1366465544
Name:DESAI, VYOMESH B (DMD)
Entity Type:Individual
Prefix:
First Name:VYOMESH
Middle Name:B
Last Name:DESAI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:385 STATE ROUTE 18
Mailing Address - Street 2:UNIT A
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-5703
Mailing Address - Country:US
Mailing Address - Phone:732-613-8765
Mailing Address - Fax:732-613-8766
Practice Address - Street 1:385 STATE ROUTE 18
Practice Address - Street 2:UNIT A
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-5703
Practice Address - Country:US
Practice Address - Phone:732-613-8765
Practice Address - Fax:732-613-8766
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI 161711223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice