Shivani Kirit Desai, DDS, MS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

12962 Issued in NC

Practice address

411 Billingsley Rd Ste 106
Charlotte, NC 28211-1066

Phone

(704) 397-4205

NPI assigned

Apr 22, 2020

Last updated

Aug 11, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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

{
    "created_epoch": "1587513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660176000000",
    "number": "1245850015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1315 HARDING PL APT 303",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282043539",
            "telephone_number": "804-514-7812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 BILLINGSLEY RD STE 106",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282111066",
            "telephone_number": "704-397-4205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESAI",
        "first_name": "SHIVANI",
        "middle_name": "KIRIT",
        "name_prefix": "Dr.",
        "credential": "DDS, MS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-22",
        "last_updated": "2022-08-11",
        "certification_date": "2022-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NC",
            "license": "12962",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mayur Pareshkumar Desai, CPP
• Neelam Samit Desai
• Niraj Suresh Desai, M.D.
• Nita Ajit Desai, MD
• Payal Chandarana Desai, MD
• Sima Ajit Desai, MD
• Urvi Gautam Desai, MD
• Raynald Leon Desameau, DMD
• Janet Labayo Desamero, PA
• Andrea Mary Desantis, DO

• Pediatric Dentistry in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Pediatric Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2022; 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.