Individual provider Active NPI

Maria Qasim Khan

  • Orofacial Pain Dentistry
  • Sterling Heights, MI
National Provider Identifier
1417614785
Registry record updated Nov 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orofacial Pain DentistryTaxonomy code 1223X2210X
License
37980 Issued in TX
Practice address
36420 Dominion Cir
Sterling Heights, MI 48310-7459
Phone
(586) 489-9467
NPI assigned
Nov 22, 2021
Last updated
Nov 22, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orofacial Pain Dentistry 1223X2210X 37980 TX Primary

Addresses

Primary practice location

36420 Dominion Cir
Sterling Heights, MI 48310-7459

Mailing address

36420 Dominion Cir
Sterling Heights, MI 48310-7459

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20260623001957 NC Practitioner - DentistPractitioner - Orofacial Pain 7719450642 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
DentistAlso: Orofacial Pain
Education
State University of New York at Buffalo School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hpu Health LLCGroup PAC ID 2860831989, 5 clinicians

Practice addresses (Care Compare)

511 Greensboro St
Asheboro, NC 27203-4736
Phone (336) 579-1451

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
37980TXMDOrofacial Pain Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Hpu Health LLC PastSince Mar 1, 2024 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1637539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637539200000",
    "number": "1417614785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36420 DOMINION CIR",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483107459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36420 DOMINION CIR",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483107459",
            "telephone_number": "586-489-9467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "MARIA",
        "middle_name": "QASIM",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-22",
        "last_updated": "2021-11-22",
        "certification_date": "2021-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X2210X",
            "taxonomy_group": "",
            "desc": "Dentist, Orofacial Pain",
            "state": "TX",
            "license": "37980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sterling Heights, MI

Sources for this page

Verify at the official NPI Registry.