Ahmad Al Khafaji, DMD

Individual provider Active NPI Dentist · Hanover, MA

NPI 1487328563 · NPPES record last updated May 15, 2024

Key facts

NPI
1487328563
Entity type
Individual (NPI type 1)
Primary specialty
Dentist 122300000X
License
DN1859237 (MA)
Practice address
20 East St
Hanover, MA 02339-1638
Phone
(781) 826-4499
Fax
(603) 546-0755
NPI assigned
Aug 3, 2021
Sex
Male
Sole proprietor
No

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
DN1859237MAMDDentist
04675NHMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Hanover Aligners and Braces PLLC Dentist Current Accepting new patients
Granite Fields Dental, PLLC Past
since Aug 1, 2021
Accepting new patients
Nashua Area Family Dentistry General Practice Past
since Aug 1, 2021
Accepting new patients

Locations

20 East St
Hanover, MA 02339
Phone (781) 826-1150

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 04675 NH
Dentist 122300000X DN1859237 MA Yes

Addresses

Primary practice location

20 East St
Hanover, MA 02339-1638

Mailing address

16 Central Ave
Newtonville, MA 02460-1707
Phone (470) 892-8847

Other providers in Hanover, MA

All providers in Hanover, MA · Dentist in Massachusetts

Sources for this page

Verify at the official NPI Registry.