Izaz M. Khan, D.M.D.

Primary specialty

DentistTaxonomy code 122300000X

License

011480 Issued in CT

Practice address

58 W Main St Ste 1
Plainville, CT 06062-1993

Phone

(860) 400-0196

Fax

(860) 400-0198

NPI assigned

Jul 3, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

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

Locations

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.

• Ikon Dental Group LLC

  • Dental Clinic/Center
  • Plainville, CT
  • NPI 1063922581
  NPD Authorized official
• CT Dental LLC

  dba Connecticut Family Dental

  • General Practice Dentistry
  • Waterbury, CT
  • NPI 1881987964
  NPD (past)

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

{
    "created_epoch": "1404345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691280000000",
    "number": "1376959890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "247 COTTONWOOD RD",
            "city": "NEWINGTON",
            "state": "CT",
            "postal_code": "061114218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "58 W MAIN ST STE 1",
            "city": "PLAINVILLE",
            "state": "CT",
            "postal_code": "060621993",
            "telephone_number": "860-400-0196",
            "fax_number": "860-400-0198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "IZAZ",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-03",
        "last_updated": "2023-08-06",
        "certification_date": "2023-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CT",
            "license": "011480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephen A Kei, M.D.
• Elizabeth Hopkins Kelley, MSW
• Jeffrey Kew
• Key Homes Marketing
• Keyndra Lewis LMFT LLC
• Sotheang Terry Khieu
• Yuriy Khoma
• Monika E. Kieltyka, FNP
• Megan Squadrito Kiely
• James Kilgus, RPH

• Dentist in Plainville, CT
• Providers in Plainville, CT by specialty
• Dentist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2023; 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.