Active NPI
Prachi Rakesh Desai, DMD
- General Practice Dentistry
- Beloit, WI
National Provider Identifier
1700625340
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 6001609
- Practice address
- 74 Eclipse Ctr
Beloit, WI 53511-3550 - Phone
- (608) 361-0311
- NPI assigned
- May 22, 2024
- Last updated
- Jun 26, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 6001609 | WI | Primary |
Addresses
Primary practice location
74 Eclipse Ctr
Beloit, WI 53511-3550
Mailing address
74 Eclipse Ctr
Beloit, WI 53511-3550
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
| License | State | Type | Specialty |
|---|---|---|---|
| 6001609 | WI | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Birth Gardens LLC | Past | Accepting new patients | |
| The Lactation Network LLC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1716336000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719360000000",
"number": "1700625340",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "74 ECLIPSE CTR",
"city": "BELOIT",
"state": "WI",
"postal_code": "535113550"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "74 ECLIPSE CTR",
"city": "BELOIT",
"state": "WI",
"postal_code": "535113550",
"telephone_number": "608-361-0311"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DESAI",
"first_name": "PRACHI",
"middle_name": "RAKESH",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-05-22",
"last_updated": "2024-06-26",
"certification_date": "2024-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "WI",
"license": "6001609",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Beloit, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.