Active NPI
Alfred G Khallouf, DDS
- Dentist
- Allentown, PA
National Provider Identifier
1619969375
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DS035075
- Practice address
- 536 E Tioga St
Allentown, PA 18103-8213 - Phone
- (301) 412-9252
- NPI assigned
- Aug 18, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DS035075 | PA | Primary |
Addresses
Primary practice location
536 E Tioga St
Allentown, PA 18103-8213
Mailing address
691 Dixon St
Allentown, PA 18103-4979
Phone (484) 221-9397
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS035075 | PA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124323200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1254268800000",
"number": "1619969375",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "691 DIXON ST",
"city": "ALLENTOWN",
"state": "PA",
"postal_code": "181034979",
"telephone_number": "484-221-9397"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "536 E TIOGA ST",
"city": "ALLENTOWN",
"state": "PA",
"postal_code": "181038213",
"telephone_number": "301-412-9252"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHALLOUF",
"first_name": "ALFRED",
"middle_name": "G",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-08-18",
"last_updated": "2009-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "PA",
"license": "DS035075",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Allentown, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.