MEDICARE: SONAL 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	122300000X	Dentist	0025736	TX

General Provider Information

NPI Number	:	1891009692
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SONAL DESAI DDS

Provider Business Mailing Address
First Line	:	4913 RUFE SNOW DR
Second Line	:	104
City	:	NORTH RICHLAND HILLS
State	:	TX
Zip	:	76180-7856
Country	:	US
Telephone Number	:	817-656-2945
Fax Number	:	817-656-1695

Provider Business Practice Location Address
First Line	:	4913 RUFE SNOW DR
Second Line	:	104
City	:	NORTH RICHLAND HILLS
State	:	TX
Zip	:	76180-7856
Country	:	US
Telephone Number	:	817-656-2945
Fax Number	:	817-656-1695

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

Provider Enumeration Date	:	08/04/2010
Last Update Date	:	08/23/2022

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