Individual provider Active NPI

Muhammad Shoaib Khan, DMD

  • General Practice Dentistry
  • Arlington Heights, IL
National Provider Identifier
1073659405
Registry record updated Nov 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019-027500 Issued in IL
Practice address
1614 W Central Rd
Suite 111
Arlington Heights, IL 60005-2490
Phone
(847) 253-8598
Fax
(847) 253-8598
NPI assigned
Jan 30, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 19, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 019-027500 IL Primary

Addresses

Primary practice location

1614 W Central Rd
Suite 111
Arlington Heights, IL 60005-2490

Mailing address

1614 W Central Rd
Suite 111
Arlington Heights, IL 60005-2490
Phone (847) 253-8598

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20150603002671 IL Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 1456672344

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019-027500ILMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1227052800000",
    "number": "1073659405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1614 W CENTRAL RD",
            "address_2": "SUITE 111",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600052490",
            "telephone_number": "847-253-8598",
            "fax_number": "847-253-8598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1614 W CENTRAL RD",
            "address_2": "SUITE 111",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600052490",
            "telephone_number": "847-253-8598",
            "fax_number": "847-253-8598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "MUHAMMAD",
        "middle_name": "SHOAIB",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-30",
        "last_updated": "2008-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019-027500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington Heights, IL

Sources for this page

Verify at the official NPI Registry.