Shataj Aslam Khan, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

37914 Issued in CA

Practice address

4900 N Peck Rd
El Monte, CA 91732-1422

Phone

(626) 579-5158

Fax

(626) 579-5311

NPI assigned

Aug 16, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

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

State licenses

Practice roles

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.

• Khan Dental Corp

  • Dentist
  • El Monte, CA
  • NPI 1851342612
  NPD (past) Authorized official
• Charles Wang DDS, Professional Corporation

  • Dental Clinic/Center
  • El Monte, CA
  • NPI 1558864819
  NPD (past)

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205949005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1553 S WESTRIDGE RD",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917914314",
            "telephone_number": "626-918-7055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4900 N PECK RD",
            "city": "EL MONTE",
            "state": "CA",
            "postal_code": "917321422",
            "telephone_number": "626-579-5158",
            "fax_number": "626-579-5311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "SHATAJ",
        "middle_name": "ASLAM",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "37914",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G91149-01",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• KGK Persona Inc
• Lusine Khachatryau
• Maria Eugenia Khalatian, M.D.
• Khan Dental Corp
• Mohammad Aslam Khan, DDS
• Penthea Khaw
• Emerald Khoo, DDS
• Andrew Robert Kilgust, M.S.
• Christine Hyewon Kim
• Dayae Kim

• General Practice Dentistry in El Monte, CA
• Providers in El Monte, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.