Provider Demographics
NPI:1447290796
Name:DESAI, BHARATI B (DDS)
Entity type:Individual
Prefix:DR
First Name:BHARATI
Middle Name:B
Last Name:DESAI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8954 RESEDA BLVD
Mailing Address - Street 2:SUITE # 100
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91324-3952
Mailing Address - Country:US
Mailing Address - Phone:818-701-3010
Mailing Address - Fax:818-701-0115
Practice Address - Street 1:8954 RESEDA BLVD
Practice Address - Street 2:SUITE # 100
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91324-3952
Practice Address - Country:US
Practice Address - Phone:818-701-3010
Practice Address - Fax:818-701-0115
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-07
Last Update Date:2012-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA299151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice