Provider Demographics
NPI:1154387520
Name:DESAI, TEJAS S (DDS)
Entity type:Individual
Prefix:DR
First Name:TEJAS
Middle Name:S
Last Name:DESAI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7792 DUBLIN BLVD
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:CA
Mailing Address - Zip Code:94568-2923
Mailing Address - Country:US
Mailing Address - Phone:925-833-9800
Mailing Address - Fax:
Practice Address - Street 1:7792 DUBLIN BLVD
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:CA
Practice Address - Zip Code:94568-2923
Practice Address - Country:US
Practice Address - Phone:925-833-9800
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA455651223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice