Khan Ali Dental Corporation

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

54611 Issued in CA

Legal business name

KHAN ALI DENTAL CORPORATION

Doing business as

Kool Kidz Dentist & Orthodontics

Practice address

18 Rancho Camino Dr
Suite 104
Pomona, CA 91766-7003

Phone

(949) 378-9389

NPI assigned

Mar 29, 2014

Organization subpart

No

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

Authorized official

Name

Shehzad Khan, D.D.S.

Title

President

Phone

(949) 378-9389

Specialties & licenses 1

Addresses

Other names 1

• Kool Kidz Dentist & Orthodontics Doing business as

Locations

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

{
    "created_epoch": "1396051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1396051200000",
    "number": "1326466152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 RANCHO CAMINO DR",
            "address_2": "SUITE 104",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917667003",
            "telephone_number": "949-378-9389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 RANCHO CAMINO DR",
            "address_2": "SUITE 104",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917667003",
            "telephone_number": "949-378-9389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KHAN ALI DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-29",
        "last_updated": "2014-03-29",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "SHEHZAD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-378-9389",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "54611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kool Kidz Dentist & Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lycrea Keys
• Mary Ann Khacheryan, PHARMD
• Elhamy Fawzy Khalil, MD
• Hannah Khalil
• Imran S Khalil
• Ayaz O Khan, D.O.
• Fahad Khan, M.D.
• Mahmood A Khan, M.D.
• Mansurur R. Khan, MD
• Sadia Khan

• Orthodontics and Dentofacial Orthopedics Dentistry in Pomona, CA
• Providers in Pomona, CA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2014; 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.