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General NPI Number Information
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NPI Number | 1598971301
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Entity Type | Individual
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Provider Name | NAYANA DESAI DDS
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Gender | Female
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Dates
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Enumeration Date | 05/16/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4127 GAGE AVE
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City | BELL
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State | CA
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Zip | 90201-1128
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Country | US
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Telephone | 323-773-2931
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Fax |
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Provider Business Mailing Address
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Address Line | 2712 DEERPARK DR
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City | FULLERTON
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State | CA
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Zip | 92835-3007
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Country | US
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Telephone | 714-993-7352
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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 | 28676
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License Number State | CA
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