Phorum Desai

Primary specialty

DentistTaxonomy code 122300000X

License

A-28029 Issued in ZZ

Practice address

1919 7TH Ave S
Birmingham, AL 35233-2005

Phone

(832) 314-1819

NPI assigned

Jun 23, 2021

Sex

Female

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": "1624406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624406400000",
    "number": "1497324420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1920 3RD AVE S APT 501",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352332151",
            "telephone_number": "832-314-1819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 7TH AVE S",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352332005",
            "telephone_number": "832-314-1819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESAI",
        "first_name": "PHORUM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-23",
        "last_updated": "2021-06-23",
        "certification_date": "2021-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "ZZ",
            "license": "A-28029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Derzis, DO
• Marcia Katherine Des Jardin, MD
• Bhumit Rajendra Desai, MD
• Kuntal Desai, MD
• Pankaj Desai
• Allison Danielle Desforges, MD
• Alok Deshane, MD
• Mollie Rene Deshazo, MD
• Whitney J Detwiler, CRNA
• Joy P. Deupree, PHD, MSN, RN, WHNP

• Dentist in Birmingham, AL
• Providers in Birmingham, AL by specialty
• Dentist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2021; 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.