Healthcare Provider Details

I. General information

NPI: 1578426623
Provider Name (Legal Business Name): DESAI PERIODONTICS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2025
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7390 NW 5TH ST STE 9
PLANTATION FL
33317-1610
US

IV. Provider business mailing address

7390 NW 5TH ST STE 9
PLANTATION FL
33317-1610
US

V. Phone/Fax

Practice location:
  • Phone: 954-797-6866
  • Fax: 954-797-6869
Mailing address:
  • Phone: 954-797-6866
  • Fax: 954-797-6869

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number
License Number State

VIII. Authorized Official

Name: DR. YASH DESAI
Title or Position: OWNER
Credential: DDS
Phone: 813-400-5428