NPIMap

Organization Active NPI

Moona Khan DDS PS

Doing business as South Sound Dental Care

  • Dentist
  • Tacoma, WA
National Provider Identifier
1487992772
Registry record updated Jan 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DE00011022 Issued in WA
Legal business name
MOONA KHAN DDS PS
Doing business as
South Sound Dental Care
Practice address
2115 S 56TH St
Suite 202
Tacoma, WA 98409-6902
Phone
(253) 473-4303
Fax
(253) 473-0201
NPI assigned
Jan 22, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2013

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

Authorized official

Name
Moona Khan, DDSNPI 1700060548
Title
DDS/Owner
Phone
(253) 473-4303

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X DE00011022 WA Primary

Addresses

Primary practice location

2115 S 56TH St
Suite 202
Tacoma, WA 98409-6902

Mailing address

2115 S 56TH St
Suite 202
Tacoma, WA 98409-6902
Phone (253) 473-4303

Other names 1

  • South Sound Dental Care Doing business as

National Provider Directory

National Provider Directory

Locations

2115 S 56th St
Ste 202
Tacoma, WA 98409
Phone (253) 473-4303

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1358812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358812800000",
    "number": "1487992772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2115 S 56TH ST",
            "address_2": "SUITE 202",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984096902",
            "telephone_number": "253-473-4303",
            "fax_number": "253-473-0201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2115 S 56TH ST",
            "address_2": "SUITE 202",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984096902",
            "telephone_number": "253-473-4303",
            "fax_number": "253-473-0201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOONA KHAN DDS PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-22",
        "last_updated": "2013-01-22",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "MOONA",
        "authorized_official_title_or_position": "DDS/OWNER",
        "authorized_official_telephone_number": "253-473-4303",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE00011022",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Sound Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tacoma, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2013; 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.