Pediatric Dentistry

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

PEDIATRIC DENTISTRY

Practice address

45535 Hanford Rd
Canton, MI 48187-4595

Phone

(734) 254-0786

Fax

(734) 254-0861

NPI assigned

Jun 17, 2019

Organization subpart

No

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

Authorized official

Name

Mrs. Farah Khan, DDS,PCNPI 1548369291

Title

Pediatric Dentist

Phone

(736) 254-0786

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Locations

Practitioners 1

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

• Farah N Khan, DDS

  • Pediatric Dentistry
  • Canton, MI
  • NPI 1548369291

  General Practice

  NPD Authorized official

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

{
    "created_epoch": "1560729600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560729600000",
    "number": "1518527191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45535 HANFORD RD",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481874595",
            "telephone_number": "734-254-0786",
            "fax_number": "734-254-0861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45535 HANFORD RD",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481874595",
            "telephone_number": "734-254-0786",
            "fax_number": "734-254-0861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-17",
        "last_updated": "2019-06-17",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "FARAH",
        "authorized_official_title_or_position": "PEDIATRIC DENTIST",
        "authorized_official_telephone_number": "736-254-0786",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "DDS,PC"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONAL PROVIDER ID",
            "identifier": "1548369291",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "info@cantonpediatricsmiles.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "45535 Hanford Rd",
            "city": "Canton",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481874595",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Tarah Paulsen
• Renee Marie Pawloski, PT
• Joseph Payton, LPN
• Alex Friedman Peahl, MD
• Ryan Pecsenye, MS, LLP
• Hailey Penzak, M.S., TLLP
• Latoya Lynn Peoples-Shackelford, LPC
• Natalie Brohl Perelli, PH.D.
• Dulce Catalina Perry
• Personalized Nursing Light House Inc

• Pediatric Dentistry in Canton, MI
• Providers in Canton, MI by specialty
• Pediatric Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2019; 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.