Organization Active NPI

Khondoker and Associates PLLC

  • Dental Clinic/Center
  • Cornelius, NC
National Provider Identifier
1033980495
Registry record updated Feb 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
KHONDOKER AND ASSOCIATES PLLC
Practice address
19911 Zion Ave Ste D4
Cornelius, NC 28031-8877
Phone
(704) 887-2744
Fax
(929) 600-9712
NPI assigned
Jan 12, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2025

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

Authorized official

Name
Dr. Muhammad Khondoker, DDSNPI 1962132977
Title
Manager
Phone
(704) 887-2744

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

19911 Zion Ave Ste D4
Cornelius, NC 28031-8877

Mailing address

19911 Zion Ave Ste D4
Cornelius, NC 28031-8877
Phone (704) 887-2744

Other names 1

  • Lakehouse Dental Doing business as

National Provider Directory

National Provider Directory

Locations

10125 Perimeter Pkwy
Charlotte, NC 28216

19911 Zion Ave
Ste D4
Cornelius, NC 28031
Phone (704) 887-2744

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1705017600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739059200000",
    "number": "1033980495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19911 ZION AVE STE D4",
            "city": "CORNELIUS",
            "state": "NC",
            "postal_code": "280318877",
            "telephone_number": "704-887-2744",
            "fax_number": "929-600-9712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19911 ZION AVE STE D4",
            "city": "CORNELIUS",
            "state": "NC",
            "postal_code": "280318877",
            "telephone_number": "704-887-2744",
            "fax_number": "929-600-9712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KHONDOKER AND ASSOCIATES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-12",
        "last_updated": "2025-02-09",
        "certification_date": "2025-02-09",
        "status": "A",
        "authorized_official_last_name": "KHONDOKER",
        "authorized_official_first_name": "MUHAMMAD",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "704-887-2744",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakehouse Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cornelius, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2025; 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.