Khalid Sajjad, D.D.S.
Individual provider Active NPI Dentist · Merrillville, IN
NPI 1295101160 · NPPES record last updated Aug 14, 2015
Key facts
- NPI
- 1295101160
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 12012404A (IN)
- Practice address
- 757 E 81St Ave
Merrillville, IN 46410-5538 - Phone
- (219) 513-0555
- NPI assigned
- Aug 14, 2015
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12012404A | IN | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 12012404A | IN | Yes |
Addresses
Primary practice location
757 E 81St Ave
Merrillville, IN 46410-5538
Mailing address
6360 Rosemont LN
Mason, OH 45040-5770
Phone (513) 580-1011
Other providers in Merrillville, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 14, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.