Provider Demographics
NPI:1558344556
Name:DESAI, SWATI P (DDS)
Entity Type:Individual
Prefix:DR
First Name:SWATI
Middle Name:P
Last Name:DESAI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:436A S BROADWAY
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10705-2339
Mailing Address - Country:US
Mailing Address - Phone:914-968-3330
Mailing Address - Fax:914-923-8546
Practice Address - Street 1:436A S BROADWAY
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10705-2339
Practice Address - Country:US
Practice Address - Phone:914-968-3330
Practice Address - Fax:914-923-8546
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0411641223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01052368Medicaid