Provider Demographics
NPI:1841289543
Name:DESAI, DINESH C (DDS)
Entity type:Individual
Prefix:DR
First Name:DINESH
Middle Name:C
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 1:1715 KENNEDY BLVD
Mailing Address - Street 2:# 2E
Mailing Address - City:NORTH BERGEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07047-6349
Mailing Address - Country:US
Mailing Address - Phone:201-867-6453
Mailing Address - Fax:
Practice Address - Street 1:1 HANSON PL
Practice Address - Street 2:SUITE 1310
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11243-2907
Practice Address - Country:US
Practice Address - Phone:718-857-8259
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0379941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice