Healthcare Provider Details
I. General information
NPI: 1700711322
Provider Name (Legal Business Name): RIDDHI DESAI DMD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3130 POTOMAC AVE
ARLINGTON VA
22202-4570
US
IV. Provider business mailing address
1840 POTOMAC GREENS DR
ALEXANDRIA VA
22314-6236
US
V. Phone/Fax
- Phone: 703-202-1171
- Fax: 703-202-1187
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223X0400X |
| Taxonomy | Orthodontics and Dentofacial Orthopedics Dentistry |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
RIDDHI
DESAI
Title or Position: ORTHODONTIST
Credential: DMD, MS, MBA
Phone: 814-233-6460