Mohammed Hyder Ali Khan

Primary specialty

DentistTaxonomy code 122300000X

License

12015053A Issued in IN

Practice address

1011 Michigan Ave
La Porte, IN 46350-3506

Phone

(219) 727-8015

NPI assigned

Mar 16, 2026

Last updated

Jun 8, 2026By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1773619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780876800000",
    "number": "1467300509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 MICHIGAN AVE",
            "city": "LA PORTE",
            "state": "IN",
            "postal_code": "463503506",
            "telephone_number": "219-727-8015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 MICHIGAN AVE",
            "city": "LA PORTE",
            "state": "IN",
            "postal_code": "463503506",
            "telephone_number": "219-727-8015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "MOHAMMED",
        "middle_name": "HYDER ALI",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-03-16",
        "last_updated": "2026-06-08",
        "certification_date": "2026-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12015053A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Raymond Joseph Keener, MSN FNP-BC
• Kimly Keeton, LCSW, LCAC
• Rachel N Kennedy, FNP
• Keys Counseling, Inc
• Faiz Ullah Khan, MD
• Shaan Khan, M.D.
• Jessica Ann Kidwell-Saboski, LSW
• Cary Kirk, RN
• Emily Kirk
• Delaney Rae Kirkendall, LSW

• Dentist in La Porte, IN
• Providers in La Porte, IN by specialty
• Dentist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2026; 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.