Mansoor Irshad Khan, BDS, AEGD,FAGD

Primary specialty

DentistTaxonomy code 122300000X

License

DN 20334 Issued in FL

Practice address

1573 Saxon Blvd Ste 100&101
Deltona, FL 32725-5833

Phone

(386) 218-0046

NPI assigned

May 10, 2011

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

Enrolled in FL

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

Networks

• Freedom Health HMO Network

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

{
    "created_epoch": "1304985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581897600000",
    "number": "1275825176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1573 SAXON BLVD STE 100&101",
            "city": "DELTONA",
            "state": "FL",
            "postal_code": "327255833",
            "telephone_number": "286-218-0046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1573 SAXON BLVD STE 100&101",
            "city": "DELTONA",
            "state": "FL",
            "postal_code": "327255833",
            "telephone_number": "386-218-0046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "MANSOOR",
        "middle_name": "IRSHAD",
        "name_prefix": "Dr.",
        "credential": "BDS, AEGD,FAGD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-10",
        "last_updated": "2020-02-17",
        "certification_date": "2020-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN 20334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Lee Kennedy, APRN
• Jean M Kent, L.M.T.
• Malia Kent, PMHNP-BC
• Robert E Kent, DO
• Cindy Lynn Keshavarz, AGNP
• Tiffany Varela Khan, APRN
• Alex David Khromov, M.D.
• Ashley Nichole Kiely, PT, DPT
• Anthony Kim, D.C.
• Julie Kimberly, RRT

• Dentist in Deltona, FL
• Providers in Deltona, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2020; 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.