Individual provider Active NPI

Bilal Hussain Khan

  • Endodontics
  • Richmond, VA
National Provider Identifier
1073175709
Registry record updated Jun 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
0401417631 Issued in VA
Practice address
6750 Forest Hill Ave Ste a
Richmond, VA 23225-1802
Phone
(804) 272-7040
NPI assigned
Jul 2, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 0401417631 VA Primary

Addresses

Primary practice location

6750 Forest Hill Ave Ste a
Richmond, VA 23225-1802

Mailing address

6750 Forest Hill Ave Ste a
Richmond, VA 23225-1802
Phone (804) 272-7040

Other practice location 1

3904 Hull Street Rd Ste A
Richmond, VA 23224-1714
Phone (804) 233-0007

Other practice location 2

635 Albany St
Boston, MA 02118-3550
Phone (617) 358-8300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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

Enrollment IDStateProvider typePAC IDDetails
I20190726001449 CT Order and Referring Only - DentistPractitioner - Dentist 1153657226

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0401417631VAMDEndodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Family Dental of Virginia, LLC PastSince Aug 1, 2021 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": "1562025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719705600000",
    "number": "1073175709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6750 FOREST HILL AVE STE A",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232251802",
            "telephone_number": "804-272-7040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6750 FOREST HILL AVE STE A",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232251802",
            "telephone_number": "804-272-7040"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3904 Hull Street Rd Ste A",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "VA",
            "postal_code": "232241714",
            "country_code": "US",
            "telephone_number": "804-233-0007",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "635 Albany St",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021183550",
            "country_code": "US",
            "telephone_number": "617-358-8300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHAN",
        "first_name": "BILAL",
        "middle_name": "HUSSAIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-02",
        "last_updated": "2024-06-30",
        "certification_date": "2024-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "VA",
            "license": "0401417631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

Verify at the official NPI Registry.