Hammad Khan, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

21428 Issued in MA

Practice address

899 S Weber Rd Ste B
Bolingbrook, IL 60490-5489

Phone

(630) 277-9373

NPI assigned

Dec 21, 2006

Sex

Male

Sole proprietor

Yes

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 IL

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

State licenses

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691625600000",
    "number": "1457415424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "899 S WEBER RD STE B",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604905489",
            "telephone_number": "630-277-9373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "899 S WEBER RD STE B",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604905489",
            "telephone_number": "630-277-9373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "HAMMAD",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-21",
        "last_updated": "2023-08-10",
        "certification_date": "2023-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019026111",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "21428",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ken Gray Company Inc.
• Ken Gray Company Inc. (Bolingbrook Express Medical Transport)
• Sibtain Kerai, D.D.S.
• Jean E. Keskitalo, O.D.
• Faisal Khan
• Haroon Khan, PHARMACIST
• Vinod V Khandate, PT
• Aaron K Kim, DPM
• Byoung O Kim, MD
• Eliza Kim, DMD

• Dentist in Bolingbrook, IL
• Providers in Bolingbrook, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 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.