Samer K Khattab, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

0401413570 Issued in VA

Practice address

9010 Lorton Station Blvd
135
Lorton, VA 22079-4792

Phone

(210) 430-2740

NPI assigned

Jun 20, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Lortontown Dental

  • Dental Clinic/Center
  • Lorton, VA
  • NPI 1669097044
  NPD Authorized official

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

{
    "created_epoch": "1340150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452384000000",
    "number": "1013270594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9010 LORTON STATION BLVD",
            "address_2": "135",
            "city": "LORTON",
            "state": "VA",
            "postal_code": "220794792",
            "telephone_number": "210-430-2740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9010 LORTON STATION BLVD",
            "address_2": "135",
            "city": "LORTON",
            "state": "VA",
            "postal_code": "220794792",
            "telephone_number": "210-430-2740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHATTAB",
        "first_name": "SAMER",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-20",
        "last_updated": "2016-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401413570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• KC Pharmacy Healthmart Inc
• KC Pharmacy LLC
• Metsihet L Kebede
• Angelynn G Keighin, BEHAVIOR TECHNICIAN
• Key Affinity Healthcare LLC
• Daneshia Michelle Kidd, OT
• Lila Kim, D.D.S
• Kind Transportation LLC
• Brigid Morgan King, DPT
• Lisa Ellen Knight, DPT

• Dentist in Lorton, VA
• Providers in Lorton, VA by specialty
• Dentist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2016; 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.