Provider Demographics
NPI:1417624776
Name:DESAI, ADITI (DMD)
Entity type:Individual
Prefix:DR
First Name:ADITI
Middle Name:
Last Name:DESAI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3384 DRAYTON PL
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-1308
Mailing Address - Country:US
Mailing Address - Phone:832-977-8815
Mailing Address - Fax:832-977-8815
Practice Address - Street 1:748 STATE ROUTE 28 STE A
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:OH
Practice Address - Zip Code:45150-1806
Practice Address - Country:US
Practice Address - Phone:513-248-2626
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-25
Last Update Date:2025-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.0277961223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty