Individual provider Active NPI

Hiral Desai, DDS

  • Dentist
  • Tustin, CA
National Provider Identifier
1770129926
Registry record updated Mar 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
104212 Issued in CA
Practice address
604 E 1St St
Tustin, CA 92780-3418
Phone
(145) 059-4627
Fax
(714) 505-2559
NPI assigned
Nov 22, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2026

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 104212 CA
Customized Equipment (DME) 332BC3200X
Orofacial Pain Dentistry 1223X2210X 104212 CA
Periodontics 1223P0300X 104212 CA
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 104212 CA
Dentist 122300000X 104212 CA Primary

Addresses

Primary practice location

604 E 1St St
Tustin, CA 92780-3418

Mailing address

604 E 1St St
Tustin, CA 92780-3418
Phone (714) 505-9462

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230706001365 CA Practitioner - DentistPractitioner - Maxillofacial Surgery 9234597741

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
104212CAMDOrofacial Pain Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Snoozx-Ai General Practice CurrentSince May 23, 2024 Accepting new patients

Locations

604 E 1st St
Tustin, CA 92780
Phone (424) 303-1665

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1574380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772496000000",
    "number": "1770129926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "604 E 1ST ST",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803418",
            "telephone_number": "714-505-9462",
            "fax_number": "714-505-2559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 E 1ST ST",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803418",
            "telephone_number": "145-059-4627",
            "fax_number": "714-505-2559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESAI",
        "first_name": "HIRAL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-22",
        "last_updated": "2026-03-03",
        "certification_date": "2026-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "104212",
            "primary": false
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223X2210X",
            "taxonomy_group": "",
            "desc": "Dentist, Orofacial Pain",
            "state": "CA",
            "license": "104212",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "104212",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "104212",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "104212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tustin, CA

Sources for this page

Verify at the official NPI Registry.