Provider Demographics
NPI:1780775023
Name:DESAI, NITA HIREN (DDS)
Entity type:Individual
Prefix:
First Name:NITA
Middle Name:HIREN
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 1:28535 ORCHARD LAKE RD
Mailing Address - Street 2:STE 400
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334
Mailing Address - Country:US
Mailing Address - Phone:248-848-1126
Mailing Address - Fax:248-848-1190
Practice Address - Street 1:28535 ORCHARD LAKE ROAD
Practice Address - Street 2:STE 400
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334
Practice Address - Country:US
Practice Address - Phone:248-848-1126
Practice Address - Fax:248-848-1190
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2016-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901016619122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist