Individual provider Active NPI

Krunal Desai, DDS

  • General Practice Dentistry
  • Desoto, TX
National Provider Identifier
1083979744
Registry record updated Jul 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
28165 Issued in TX
Practice address
921 W Belt Line Rd
Suite 117
Desoto, TX 75115-3822
Phone
(732) 599-8734
NPI assigned
Jul 9, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2012

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 28165 TX Primary

Addresses

Primary practice location

921 W Belt Line Rd
Suite 117
Desoto, TX 75115-3822

Mailing address

921 W Belt Line Rd
Suite 117
Desoto, TX 75115-3822
Phone (732) 599-8734

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
28165TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Keller Desai Dental PLLC General Practice Current Accepting new patients

Locations

9500 Ray White Rd
Ste 105
Fort Worth, TX 76244
Phone (817) 242-2738

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1341792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341792000000",
    "number": "1083979744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "921 W BELT LINE RD",
            "address_2": "SUITE 117",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751153822",
            "telephone_number": "732-599-8734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "921 W BELT LINE RD",
            "address_2": "SUITE 117",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751153822",
            "telephone_number": "732-599-8734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESAI",
        "first_name": "KRUNAL",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-07-09",
        "last_updated": "2012-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "28165",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Desoto, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.