MEDICARE: DR. DINESH C DESAI DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	037994	NY

General Provider Information

NPI Number	:	1841289543
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DINESH C DESAI DDS

Provider Business Mailing Address
First Line	:	1715 KENNEDY BLVD
Second Line	:	# 2E
City	:	NORTH BERGEN
State	:	NJ
Zip	:	07047-6349
Country	:	US
Telephone Number	:	201-867-6453
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 HANSON PL
Second Line	:	SUITE 1310
City	:	BROOKLYN
State	:	NY
Zip	:	11243-2907
Country	:	US
Telephone Number	:	718-857-8259
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/17/2005
Last Update Date	:	07/08/2007

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