Individual provider Active NPI

Jagruti D. Desai, D.D.S.

  • General Practice Dentistry
  • Hershey, PA
National Provider Identifier
1073645214
Registry record updated Jul 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS036228 Issued in PA
Practice address
10 W Chocolate Ave
Hershey, PA 17033-1472
Phone
(717) 534-1135
Fax
(717) 534-1449
NPI assigned
Mar 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DS036228 PA Primary

Addresses

Primary practice location

10 W Chocolate Ave
Hershey, PA 17033-1472

Mailing address

1255 Windsor Rd
Mechanicsburg, PA 17050-6618
Phone (717) 497-1097

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160418001736 PA Order and Referring Only - DentistPractitioner - Dentist 3173821501

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184716800000",
    "number": "1073645214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1255 WINDSOR RD",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "170506618",
            "telephone_number": "717-497-1097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 W CHOCOLATE AVE",
            "city": "HERSHEY",
            "state": "PA",
            "postal_code": "170331472",
            "telephone_number": "717-534-1135",
            "fax_number": "717-534-1449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESAI",
        "first_name": "JAGRUTI",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-12",
        "last_updated": "2007-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS036228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hershey, PA

Sources for this page

Verify at the official NPI Registry.