Individual provider Active NPI

Sakina Qayyum Khambaty, DMD

  • General Practice Dentistry
  • Irving, TX
National Provider Identifier
1023245909
Registry record updated Feb 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
29731 Issued in TX
Practice address
510 Ranch TRL Ste 102
Irving, TX 75063-4880
Phone
(972) 597-2227
Fax
(972) 597-2225
NPI assigned
Jun 17, 2009
Last updated
Feb 18, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 18, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN18689 FL
Dentist 122300000X 019.028499 IL
General Practice Dentistry 1223G0001X 29731 TX Primary

Addresses

Primary practice location

510 Ranch TRL Ste 102
Irving, TX 75063-4880

Mailing address

510 Ranch TRL Ste 102
Irving, TX 75063-4880
Phone (972) 597-2227

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DN18689FLMDDentist
019.028499ILMDDentist
29731TXMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1245196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613606400000",
    "number": "1023245909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 RANCH TRL STE 102",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750634880",
            "telephone_number": "972-597-2227",
            "fax_number": "972-597-2225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 RANCH TRL STE 102",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750634880",
            "telephone_number": "972-597-2227",
            "fax_number": "972-597-2225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAMBATY",
        "first_name": "SAKINA",
        "middle_name": "QAYYUM",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-17",
        "last_updated": "2021-02-18",
        "certification_date": "2021-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN18689",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019.028499",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "29731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irving, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2021; 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.