Active NPI
Naman Desai
- Oral and Maxillofacial Surgery (Dentist)
- Tustin, CA
National Provider Identifier
1689040115
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)
- License
- 64344
- Practice address
- 13132 Newport Ave Ste 230
Tustin, CA 92780-3429 - Phone
- (657) 231-2880
- NPI assigned
- Aug 19, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 64344 | CA | |
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | 64344 | CA | Primary |
Addresses
Primary practice location
13132 Newport Ave Ste 230
Tustin, CA 92780-3429
Mailing address
1100 N State St
RM A3C
Los Angeles, CA 90033
Other practice location 1
1100 N State St
Rm A3C
Los Angeles, CA 90033-5000
Phone (323) 409-5013
Other practice location 2
1800 N Bristol St
Santa Ana, CA 92706-3336
Phone (714) 541-4411
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230411001481 | CA | Practitioner - Oral Surgery | 3072988740 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 64344 | CA | MD | Oral and Maxillofacial Surgery (Dentist) |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1439942400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1595289600000",
"number": "1689040115",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1100 N STATE ST",
"address_2": "RM A3C",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "90033"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13132 NEWPORT AVE STE 230",
"city": "TUSTIN",
"state": "CA",
"postal_code": "927803429",
"telephone_number": "657-231-2880"
}
],
"practiceLocations": [
{
"address_1": "1100 N State St",
"address_2": "Rm A3C",
"address_purpose": "LOCATION",
"city": "Los Angeles",
"state": "CA",
"postal_code": "900335000",
"country_code": "US",
"telephone_number": "323-409-5013",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1800 N Bristol St",
"address_purpose": "LOCATION",
"city": "Santa Ana",
"state": "CA",
"postal_code": "927063336",
"country_code": "US",
"telephone_number": "714-541-4411",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DESAI",
"first_name": "NAMAN",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-08-19",
"last_updated": "2020-07-21",
"certification_date": "2020-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "64344",
"primary": false
},
{
"code": "1223S0112X",
"taxonomy_group": "",
"desc": "Dentist, Oral and Maxillofacial Surgery",
"state": "CA",
"license": "64344",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tustin, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.