Khawaja Dental, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN013647 Issued in GA

Legal business name

KHAWAJA DENTAL, LLC

Practice address

775 S Park St
Suite 101
Carrollton, GA 30117-3825

Phone

(404) 545-2452

NPI assigned

Dec 19, 2011

Organization subpart

No

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

Authorized official

Name

Mrs. Afsheen Afzal Khawaja, DMD

Title

Owner/Dentist

Phone

(770) 214-2504

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1324252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1324252800000",
    "number": "1396014452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "775 S PARK ST",
            "address_2": "SUITE 101",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301173825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "775 S PARK ST",
            "address_2": "SUITE 101",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301173825",
            "telephone_number": "404-545-2452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KHAWAJA DENTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-19",
        "last_updated": "2011-12-19",
        "status": "A",
        "authorized_official_last_name": "KHAWAJA",
        "authorized_official_first_name": "AFSHEEN",
        "authorized_official_middle_name": "AFZAL",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "770-214-2504",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN013647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danielle Hope Kelly
• Kyle Garrett Kelly, CRNA
• Jailyn S Kendrick, RN
• Nikki Kennedy
• Cathleen E Kessler, NP
• Shazib N. Khawaja, MD
• Kallista Kilgore, NP
• Shanequa Kimble, LCSW
• Jacob Mitchell Kincaid
• Pamela Kinnebrew

• General Practice Dentistry in Carrollton, GA
• Providers in Carrollton, GA by specialty
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2011; 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.