TX-Desai Dental-Selma PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

29090 Issued in TX

Legal business name

TX-DESAI DENTAL-SELMA PLLC

Practice address

8143 Agora Pkwy
105
Selma, TX 78154-1341

Phone

(315) 454-6000

NPI assigned

Aug 6, 2013

Organization subpart

No

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

Authorized official

Name

Jagruti Desai

Title

Owner

Phone

(315) 454-6000

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1375747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375747200000",
    "number": "1902238587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3189",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132203189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8143 AGORA PKWY",
            "address_2": "105",
            "city": "SELMA",
            "state": "TX",
            "postal_code": "781541341",
            "telephone_number": "315-454-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TX-DESAI DENTAL-SELMA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-06",
        "last_updated": "2013-08-06",
        "status": "A",
        "authorized_official_last_name": "DESAI",
        "authorized_official_first_name": "JAGRUTI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "315-454-6000"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "29090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Selma, TX
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2013; 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.