Adiha Ali Khan, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

33251 Issued in TX

Practice address

90 Oak Dr Unit C
Lake Jackson, TX 77566-5201

Phone

(979) 583-6005

NPI assigned

Aug 4, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1501804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501804800000",
    "number": "1114442787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4922 KIRBSTER LN",
            "city": "MISSOURI CITY",
            "state": "TX",
            "postal_code": "774591257",
            "telephone_number": "901-598-0399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 OAK DR UNIT C",
            "city": "LAKE JACKSON",
            "state": "TX",
            "postal_code": "775665201",
            "telephone_number": "979-583-6005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "ADIHA",
        "middle_name": "ALI",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-04",
        "last_updated": "2017-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "33251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathleen E Sommers (Parking Way Pediatrics)
• Alyssa Dawn Kelly, LPTA
• Katherine Kemp, MOTR/L
• Deborah Kennemer, COTA
• Jade G Kestian
• Kian Nikdel DDS MSD PLLC (Lake Jackson Root Canal Specialists)
• Samantha Diane Kibodeaux, RPH
• Kids Way Clinic
• Jeremy Ray Kier
• Patricia Kilian, CRNA

• Dentist in Lake Jackson, TX
• Providers in Lake Jackson, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.