Mohammad Abbas Khan, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DN1857790 Issued in MA

Practice address

101 Cornerstone Dr
South Windsor, CT 06074-6302

Phone

(617) 637-3637

NPI assigned

Oct 11, 2017

Last updated

Jun 27, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Enrolled in MA

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Gorgeous Smiles Dental Hartford

  dba Dental Smiles of Hartford

  • General Practice Dentistry
  • Hartford, CT
  • NPI 1548026685
  NPD
• Gorgeous Smiles Dental Southington

  dba Gorgeous Smiles Southington

  • General Practice Dentistry
  • Southington, CT
  • NPI 1831966936
  NPD
• Gorgeous Smiles Dental, PC

  dba First Line Dental

  • General Practice Dentistry
  • Manchester, CT
  • NPI 1255027850
  NPD
• Advance Dental Unionville PC

  • Dental Clinic/Center
  • Unionville, CT
  • NPI 1174049373
  NPD (past)

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

{
    "created_epoch": "1507680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719446400000",
    "number": "1366952897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 CORNERSTONE DR",
            "city": "SOUTH WINDSOR",
            "state": "CT",
            "postal_code": "060746302",
            "telephone_number": "617-637-3637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 CORNERSTONE DR",
            "city": "SOUTH WINDSOR",
            "state": "CT",
            "postal_code": "060746302",
            "telephone_number": "617-637-3637"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15 New Britain Ave",
            "address_purpose": "LOCATION",
            "city": "Unionville",
            "state": "CT",
            "postal_code": "060851277",
            "country_code": "US",
            "telephone_number": "860-673-2455",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1985 Main St Ste F",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "MA",
            "postal_code": "011031016",
            "country_code": "US",
            "telephone_number": "413-747-0400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHAN",
        "first_name": "MOHAMMAD",
        "middle_name": "ABBAS",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-11",
        "last_updated": "2024-06-27",
        "certification_date": "2024-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DN1857790",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "12164",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stacy Karpowitz, L.M.F.T.
• Kathleen M. Friend LMFT LLC
• Navneet Kaur, APRN, FNP-BC
• Kara Greenleat Keeton, M.D.
• Collette Keise
• Muhammad Riaz Khan, M.D.
• Kind Compassionate Relief KCR
• Jessica King, O.D.
• Lisa Moriarty Kirschner, NP
• Jeanne Leavey Kmetz, LPC, MA

• Dentist in South Windsor, CT
• Providers in South Windsor, CT by specialty
• Dentist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2024; 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.