Active NPI
Robin Renee Khan, D.D.S.
- General Practice Dentistry
- Omaha, NE
National Provider Identifier
1336242452
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 6090
- Practice address
- 3631 N 129TH St
Omaha, NE 68164-5211 - Phone
- (402) 493-2112
- Fax
- (402) 493-8399
- NPI assigned
- Sep 6, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 6090 | NE | Primary |
Addresses
Primary practice location
3631 N 129TH St
Omaha, NE 68164-5211
Mailing address
260 S 208TH St
Elkhorn, NE 68022-1810
Phone (402) 493-2112
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6090 | NE | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157500800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1351123200000",
"number": "1336242452",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "260 S 208TH ST",
"city": "ELKHORN",
"state": "NE",
"postal_code": "680221810",
"telephone_number": "402-493-2112",
"fax_number": "402-493-8399"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3631 N 129TH ST",
"city": "OMAHA",
"state": "NE",
"postal_code": "681645211",
"telephone_number": "402-493-2112",
"fax_number": "402-493-8399"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHAN",
"first_name": "ROBIN",
"middle_name": "RENEE",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-06",
"last_updated": "2012-10-25",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NE",
"license": "6090",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Omaha, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.