Khaled Y. Shabany, D.M.D., M.S.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

2002003037 Issued in MO

Practice address

443 N New Ballas Rd Ste 244
Creve Coeur, MO 63141-6800

Phone

(314) 755-1542

Fax

(314) 755-1546

NPI assigned

Nov 21, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Advanced Dental Care of the Midwest, LTD

  dba Metro West Dental & Implant Institute

  • Dental Clinic/Center
  • Creve Coeur, MO
  • NPI 1669187845
  NPD Authorized official
• Metro East Periodontics, PLLC

  dba Metro East Dental Implants & Periodontics

  • Dental Clinic/Center
  • East Alton, IL
  • NPI 1801509666

  Periodontics

  NPD Authorized official

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674172800000",
    "number": "1578638375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2049 MCKELVEY RD",
            "city": "MARYLAND HEIGHTS",
            "state": "MO",
            "postal_code": "630432307",
            "telephone_number": "314-878-2111",
            "fax_number": "314-878-7648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "443 N NEW BALLAS RD STE 244",
            "city": "CREVE COEUR",
            "state": "MO",
            "postal_code": "631416800",
            "telephone_number": "314-755-1542",
            "fax_number": "314-755-1546"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "160 S Bellwood Dr Ste C",
            "address_purpose": "LOCATION",
            "city": "East Alton",
            "state": "IL",
            "postal_code": "620242086",
            "country_code": "US",
            "telephone_number": "618-258-1244",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHABANY",
        "first_name": "KHALED",
        "middle_name": "Y.",
        "name_prefix": "Dr.",
        "credential": "D.M.D., M.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-21",
        "last_updated": "2023-01-20",
        "certification_date": "2023-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2002003037",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "IL",
            "license": "021.001930",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "MO",
            "license": "2002003037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Brian Sheble, PH.D, NCSP, LPC, NCC
• Sher Institute for Reproductive Medicine

• Periodontics in Creve Coeur, MO
• Providers in Creve Coeur, MO by specialty
• Periodontics in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2023; 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.