Active NPI
Vajahat Yar Khan, BDS
- Pediatric Dentistry
- Fort Worth, TX
National Provider Identifier
1154463974
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 23077
- Practice address
- 225 NE 28TH St
Fort Worth, TX 76164-7205 - Phone
- (817) 624-0044
- Fax
- (817) 624-0041
- NPI assigned
- Feb 12, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 23077 | TX | Primary |
Addresses
Primary practice location
225 NE 28TH St
Fort Worth, TX 76164-7205
Mailing address
6103 W Masters Dr
Apt # 1214
Fort Worth, TX 76137-6865
Phone (713) 992-2114
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1826141 | Medicaid | TX |
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 |
|---|---|---|---|
| 23077 | TX | MD | Case Manager/Care Coordinator |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| South Texas Dental Associates, L.P. | Past | 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.
-
- Dentist
- Ft Worth, TX
- NPI 1447476338
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171238400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1223337600000",
"number": "1154463974",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6103 W MASTERS DR",
"address_2": "APT # 1214",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761376865",
"telephone_number": "713-992-2114"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "225 NE 28TH ST",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761647205",
"telephone_number": "817-624-0044",
"fax_number": "817-624-0041"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YAR KHAN",
"first_name": "VAJAHAT",
"name_prefix": "Dr.",
"credential": "BDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-12",
"last_updated": "2008-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "TX",
"license": "23077",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1826141",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.