Sanabil Manzoor Khattak, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

13949 Issued in NC

Practice address

108 Piccadilly Dr Ste a
Winston Salem, NC 27104-3526

Phone

(336) 760-8700

Fax

(336) 518-0415

NPI assigned

Mar 6, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1678060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730851200000",
    "number": "1033819248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 PICCADILLY DR STE A",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271043526",
            "telephone_number": "336-760-8700",
            "fax_number": "336-518-0415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 PICCADILLY DR STE A",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271043526",
            "telephone_number": "336-760-8700",
            "fax_number": "336-518-0415"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5005 Riverside Dr Unit A",
            "address_purpose": "LOCATION",
            "city": "macon",
            "state": "GA",
            "postal_code": "31210",
            "country_code": "US",
            "telephone_number": "478-405-0664",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHATTAK",
        "first_name": "SANABIL",
        "middle_name": "MANZOOR",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-06",
        "last_updated": "2024-11-06",
        "certification_date": "2024-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "13949",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN123112",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rafey Khan, MD
• Amit Khanal, MD
• Rupesh Khanal, MD
• Ashish Kumar Khanna, M.D.
• Omaditya Khanna, M.D.
• Vickas Khemsara, MD
• Maroon B Khoury, MD
• David Andrew Kibler, OT/L, CHT
• Hannah Greene Kibler, PA-C
• Domiziana Kidd, PA-C

• General Practice Dentistry in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.