Bahman Sanikhatam, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS024444L Issued in PA

Practice address

125 W City Ave
Bala Cynwyd, PA 19004-3103

Phone

(610) 667-7171

Fax

(610) 667-5121

NPI assigned

Jul 15, 2010

Last updated

Jul 15, 2010By the provider in NPPES

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sani Khatam & Anderson PC

  dba Bala Oral Health Center

  • Dentist
  • Bala Cynwyd, PA
  • NPI 1174680961
  NPD (past) Authorized official

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

{
    "created_epoch": "1279152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279152000000",
    "number": "1265745681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 W CITY AVE",
            "city": "BALA CYNWYD",
            "state": "PA",
            "postal_code": "190043103",
            "telephone_number": "610-667-7171",
            "fax_number": "610-667-5121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 W CITY AVE",
            "city": "BALA CYNWYD",
            "state": "PA",
            "postal_code": "190043103",
            "telephone_number": "610-667-7171",
            "fax_number": "610-667-5121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANIKHATAM",
        "first_name": "BAHMAN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-15",
        "last_updated": "2010-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS024444L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Farida Elizabeth Saleem, MS, LMFT
• Chelsea Rose Saltzman, RD
• Sandra M. Mack (Confidential Care Counseling)
• Cheryl L Sanfacon, M.D.
• Sani Khatam & Anderson PC (Bala Oral Health Center)
• Maritza Santiago
• Lynn J Santilli
• Dawn Star Sarahs-Borchelt
• Trevor Sasek, MS, LPC
• Miriam Satz, LMSW

• General Practice Dentistry in Bala Cynwyd, PA
• Providers in Bala Cynwyd, PA by specialty
• General Practice Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.