Krishna H Desai

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D011685 Issued in AZ

Practice address

7584 E State Route 69
Prescott Valley, AZ 86314-2278

Phone

(510) 736-9890

NPI assigned

Feb 15, 2022

Last updated

Mar 30, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

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": "1644883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680134400000",
    "number": "1790430189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "172 BLACK MOUNTAIN CIR",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945366530",
            "telephone_number": "510-736-9890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7584 E STATE ROUTE 69",
            "city": "PRESCOTT VALLEY",
            "state": "AZ",
            "postal_code": "863142278",
            "telephone_number": "510-736-9890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESAI",
        "first_name": "KRISHNA",
        "middle_name": "H",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-15",
        "last_updated": "2023-03-30",
        "certification_date": "2023-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VT",
            "license": "016.0134081",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D011685",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "$$$$$$$$$",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeremy M Dellosa, LMT
• Ann M Delorme, LPC
• Joseph Demichele, RN
• Starr W Denison, MS, LPC
• Sean P Derry, LPC
• Desert Hand Therapy LLC (Desert Hand Therapy)
• Robert Proctor Diamond, M.A.
• Amy Elizabeth Dickerson, M.S.
• Kathleen Ellen Diebert, RN
• Teresa M Dingee

• General Practice Dentistry in Prescott Valley, AZ
• Providers in Prescott Valley, AZ by specialty
• General Practice Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2023; 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.