Individual provider Active NPI

Ruman U Khattak, DMD

  • Dentist
  • Feasterville Trevose, PA
National Provider Identifier
1407631906
Registry record updated Aug 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN1859960 Issued in MA
Practice address
4382 Buckfield Ter
Feasterville Trevose, PA 19053-6702
Phone
(267) 520-0673
NPI assigned
Aug 31, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN1859960 MA Primary

Addresses

Primary practice location

4382 Buckfield Ter
Feasterville Trevose, PA 19053-6702

Mailing address

4382 Buckfield Ter
Feasterville Trevose, PA 19053-6702

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DN1859960MAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1693440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693440000000",
    "number": "1407631906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4382 BUCKFIELD TER",
            "city": "FEASTERVILLE TREVOSE",
            "state": "PA",
            "postal_code": "190536702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4382 BUCKFIELD TER",
            "city": "FEASTERVILLE TREVOSE",
            "state": "PA",
            "postal_code": "190536702",
            "telephone_number": "267-520-0673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHATTAK",
        "first_name": "RUMAN",
        "middle_name": "U",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-08-31",
        "last_updated": "2023-08-31",
        "certification_date": "2023-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DN1859960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Feasterville Trevose, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2023; 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.