Individual provider Active NPI

Faisal Ali Khan, D.D.S.

  • Oral and Maxillofacial Surgery (Dentist)
  • Oak Lawn, IL
National Provider Identifier
1043385768
Registry record updated Feb 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
2901019237 Issued in MI
Practice address
4435 W 95TH St
Oak Lawn, IL 60453-2625
Phone
(708) 423-5992
Fax
(708) 423-8552
NPI assigned
Nov 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 22, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2901019237 MI
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 2901019237 MI Primary

Addresses

Primary practice location

4435 W 95TH St
Oak Lawn, IL 60453-2625

Mailing address

4435 W 95TH St
Oak Lawn, IL 60453-2625
Phone (708) 423-5992

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
2901019237MIMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Midland Oral Surgery and Implant Centers, LTD Oral and Maxillofacial Surgery PastSince Sep 5, 2015 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456099200000",
    "number": "1043385768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4435 W 95TH ST",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604532625",
            "telephone_number": "708-423-5992",
            "fax_number": "708-423-8552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4435 W 95TH ST",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604532625",
            "telephone_number": "708-423-5992",
            "fax_number": "708-423-8552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "FAISAL",
        "middle_name": "ALI",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-21",
        "last_updated": "2016-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901019237",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MI",
            "license": "2901019237",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Lawn, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 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.