Organization Active NPI

Dentists of North Glendale, LLP

Doing business as Dentists of North Glendale

  • Dentist
  • Glendale, AZ
National Provider Identifier
1518434869
Registry record updated Jun 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
DENTISTS OF NORTH GLENDALE, LLP
Doing business as
Dentists of North Glendale
Practice address
5890 W Bell Rd Ste 102
Glendale, AZ 85308-3884
Phone
(623) 232-3176
Fax
(623) 232-3176
NPI assigned
Oct 25, 2018
Last updated
Jun 14, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2022

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

Authorized official

Name
Dr. Mohammed Khakwani, DMD
Title
Owner
Phone
(623) 232-3176

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

5890 W Bell Rd Ste 102
Glendale, AZ 85308-3884

Mailing address

PO Box 920050
Dallas, TX 75392-0050
Phone (714) 845-8500

Other names 1

  • Dentists of North Glendale Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
03D2257130Dentists of North Glendale5890 W Bell Rd Ste 102, Glendale, AZ 85308Certificate of waiverMar 30, 2028

National Provider Directory

National Provider Directory

Locations

5890 W Bell Rd
Ste 102
Glendale, AZ 85308
Phone (623) 232-3176

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1540425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655164800000",
    "number": "1518434869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 920050",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753920050",
            "telephone_number": "714-845-8500",
            "fax_number": "303-952-0892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5890 W BELL RD STE 102",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853083884",
            "telephone_number": "623-232-3176",
            "fax_number": "623-232-3176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTISTS OF NORTH GLENDALE, LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-25",
        "last_updated": "2022-06-14",
        "certification_date": "2022-06-14",
        "status": "A",
        "authorized_official_last_name": "KHAKWANI",
        "authorized_official_first_name": "MOHAMMED",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "623-232-3176",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dentists of North Glendale",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Dentists of North Glendale",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.