Mazen Khalil, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901601535 Issued in MI

Practice address

3130 S Westnedge Ave
Kalamazoo, MI 49008-4927

Phone

(269) 459-9200

NPI assigned

Sep 5, 2022

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

Enrolled in MI

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

Practice roles

Locations

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.

• Pro Dental Mi 1 PC

  • General Practice Dentistry
  • Kalamazoo, MI
  • NPI 1164259438
  NPD
• D2 Dental of Michigan, P.C.

  • General Practice Dentistry
  • Kalamazoo, MI
  • NPI 1831508548
  NPD (past)

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

{
    "created_epoch": "1662336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662336000000",
    "number": "1508587080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7817 OXFORD DR",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481871337",
            "telephone_number": "313-377-1111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3130 S WESTNEDGE AVE",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490084927",
            "telephone_number": "269-459-9200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHALIL",
        "first_name": "MAZEN",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-05",
        "last_updated": "2022-09-05",
        "certification_date": "2022-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901601535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aiden Khachouf
• Mohammad M Khaghany, M.D.
• Faizan Niaz Khajar, MD
• Akbar Khalid, DO
• Saad Khalid, MD
• Salam Khalil, MD
• Anoosha Khan, MD
• Ariba Khan
• Fatima Iqbal Khan, MD
• Saima Khan, MD

• General Practice Dentistry in Kalamazoo, MI
• Providers in Kalamazoo, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2022; 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.