Sumera Khalid, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

2901600386 Issued in MI

Practice address

22087 Knudsen Dr
Grosse Ile, MI 48138-3301

Phone

(405) 271-4000

NPI assigned

Jun 8, 2020

Sex

Female

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 9, 2020.

{
    "created_epoch": "1591574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591660800000",
    "number": "1508480328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22087 KNUDSEN DR",
            "city": "GROSSE ILE",
            "state": "MI",
            "postal_code": "481383301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22087 KNUDSEN DR",
            "city": "GROSSE ILE",
            "state": "MI",
            "postal_code": "481383301",
            "telephone_number": "405-271-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHALID",
        "first_name": "SUMERA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-08",
        "last_updated": "2020-06-09",
        "certification_date": "2020-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901600386",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deborah Joseph
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• Douglas John Kelley, D.O.
• Mounir Khaled, M.D.
• Isabella Kowal, RN
• Anthony P Kozma, DO
• Kevin Kwan
• Elizabeth A Leon, LMSW
• Lifelong Family Dentistry PLLC

• All providers in Grosse Ile, MI
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2020; 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.