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General NPI Number Information
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NPI Number | 1407988173
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Entity Type | Individual
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Provider Name | USHA DESAI DDS
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Gender | Female
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Dates
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Enumeration Date | 03/09/2007
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Last Update Date | 03/22/2017
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Provider Practice Location Address
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Address Line | 23 REYNOLDS AVE LIFE OK DENTAL LLC
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City | PARSIPPANY
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State | NJ
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Zip | 07054-3323
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Country | US
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Telephone | 973-887-3000
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Fax | 973-599-1009
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Provider Business Mailing Address
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Address Line | 23 REYNOLDS AVE
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City | PARSIPPANY
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State | NJ
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Zip | 07054-3323
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Country | US
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Telephone | 973-887-3000
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 22D102146800
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License Number State | NJ
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