Raj Ajay Desai

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

019.033372 Issued in IL

Practice address

272 S Randall Rd
Algonquin, IL 60102-9775

Phone

(858) 552-7525

NPI assigned

Jul 3, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1530576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653696000000",
    "number": "1447746334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 S PEORIA ST APT 707",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606073117",
            "telephone_number": "848-228-1848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "272 S RANDALL RD",
            "city": "ALGONQUIN",
            "state": "IL",
            "postal_code": "601029775",
            "telephone_number": "858-552-7525"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7820 S Cicero Ave",
            "address_purpose": "LOCATION",
            "city": "Burbank",
            "state": "IL",
            "postal_code": "604591584",
            "country_code": "US",
            "telephone_number": "848-228-1848",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DESAI",
        "first_name": "RAJ",
        "middle_name": "AJAY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-07-03",
        "last_updated": "2022-05-28",
        "certification_date": "2022-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "IL",
            "license": "019.033372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alyssa Demma
• Dental Care of Algonquin
• Dental Nexus PLLC
• Dental Professionals of Algonquin, P.C.
• Dermatology Specialists of Illinois, LTD
• Diamond Physical Therapy and Rehabilitation, PC
• Diana F Penuela-Oneill PC
• Jon Difatta
• Lynda Dinh
• Deidre R Dobbels, M.S. CCC-SLP

• Orthodontics and Dentofacial Orthopedics Dentistry in Algonquin, IL
• Providers in Algonquin, IL by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 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.