Provider Demographics
NPI:1487098257
Name:JAIMINI A. DESAI,D.M.D.,INC
Entity type:Organization
Organization Name:JAIMINI A. DESAI,D.M.D.,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAIMINI
Authorized Official - Middle Name:ARVIN
Authorized Official - Last Name:DESAI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:401-821-6500
Mailing Address - Street 1:80 QUAKER LN
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-0111
Mailing Address - Country:US
Mailing Address - Phone:401-821-6500
Mailing Address - Fax:
Practice Address - Street 1:80 QUAKER LN
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-0111
Practice Address - Country:US
Practice Address - Phone:401-821-6500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-24
Last Update Date:2013-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDEN02515122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty