Khalida N Stanazai, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

DS044269 Issued in PA

Practice address

2250 Millennium Way Ste 101
Enola, PA 17025-1488

Phone

(717) 972-0031

NPI assigned

Apr 21, 2019

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 NC

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

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

{
    "created_epoch": "1555804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698019200000",
    "number": "1215590690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2250 MILLENNIUM WAY STE 101",
            "city": "ENOLA",
            "state": "PA",
            "postal_code": "170251488",
            "telephone_number": "717-972-0031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2250 MILLENNIUM WAY STE 101",
            "city": "ENOLA",
            "state": "PA",
            "postal_code": "170251488",
            "telephone_number": "717-972-0031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANAZAI",
        "first_name": "KHALIDA",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-21",
        "last_updated": "2023-10-23",
        "certification_date": "2023-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS044269",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hope Soulier
• Carrie Jo Sowers, RN
• Spirit Physcian Services, Inc
• Spiritrust Lutheran Life
• Anupam Srivastava, M.D.
• John C Staretz, PHARM D.
• Alexandra Lee Stewart, MSW, LCSW
• Ashad Shahid Syed
• Tailored Glory Consulting Group
• Jessica Teeter, MPH, PA-C

• Dentist in Enola, PA
• Providers in Enola, PA by specialty
• Dentist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2023; 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.