Active NPI
Yameen Khan
- General Practice Dentistry
- Philadelphia, PA
National Provider Identifier
1104024520
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DS027532L
- Practice address
- 136 W Diamond St
Kensington Hospital Care of Dental Clinic
Philadelphia, PA 19122 - Phone
- (215) 291-6004
- NPI assigned
- Jul 6, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DS027532L | PA | Primary |
Addresses
Primary practice location
136 W Diamond St
Kensington Hospital Care of Dental Clinic
Philadelphia, PA 19122
Mailing address
219 Colt St
Pennington, NJ 08534
Phone (609) 818-0939
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 129305 | Other | PA | KEYSTONE MERCY |
| DPA0012330700001 | Medicaid | PA | |
| 2922 | Other | PA | HEALTH PARTNERS |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS027532L | PA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1183680000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1104024520",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "219 COLT ST",
"city": "PENNINGTON",
"state": "NJ",
"postal_code": "08534",
"telephone_number": "609-818-0939"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "136 W DIAMOND ST",
"address_2": "KENSINGTON HOSPITAL CARE OF DENTAL CLINIC",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "19122",
"telephone_number": "215-291-6004"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHAN",
"first_name": "YAMEEN",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-07-06",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "PA",
"license": "DS027532L",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KEYSTONE MERCY",
"identifier": "129305",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "DPA0012330700001",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PARTNERS",
"identifier": "2922",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.