Provider Demographics
NPI:1659593838
Name:BHAKTI K. DESAI, DDS, INC.
Entity Type:Organization
Organization Name:BHAKTI K. DESAI, DDS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BHAKTI
Authorized Official - Middle Name:K
Authorized Official - Last Name:DESAI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:408-926-1135
Mailing Address - Street 1:266 N JACKSON AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95116-1606
Mailing Address - Country:US
Mailing Address - Phone:406-926-1135
Mailing Address - Fax:
Practice Address - Street 1:266 N JACKSON AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95116-1606
Practice Address - Country:US
Practice Address - Phone:406-926-1135
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA358701223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty