Shahmir Akbar Khan, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

DN30021 Issued in FL

Practice address

548 W Twincourt TRL
St Augustine, FL 32095-8881

Phone

(904) 901-4684

NPI assigned

Jul 19, 2023

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1689724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745884800000",
    "number": "1285314815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W249N5245 EXECUTIVE DR STE 206",
            "city": "SUSSEX",
            "state": "WI",
            "postal_code": "530894393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "548 W TWINCOURT TRL",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320958881",
            "telephone_number": "904-901-4684"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "W249N5245 Executive Dr Ste 206",
            "address_purpose": "LOCATION",
            "city": "Sussex",
            "state": "WI",
            "postal_code": "530894393",
            "country_code": "US",
            "telephone_number": "262-246-0100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHAN",
        "first_name": "SHAHMIR",
        "middle_name": "AKBAR",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-07-19",
        "last_updated": "2025-04-29",
        "certification_date": "2025-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "WI",
            "license": "6001272",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN30021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katie Kestner
• Hailee A Ketterer
• Jacqueline Grace Kettler, OTR/L
• Kevon E. Rennie DMD, P.a.
• Mohammad Khalid, MD
• Anwar S Khokhar, MD
• Taylor Kieffer, AUD
• Erica J Kiernan, PT/OT
• Kihealth Inc.
• Maria Victoria Kilayko Sicangco, MD

• Dentist in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2025; 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.