Fahad Gul Khan, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12990 Issued in NC

Practice address

2321 Battleground Ave
Greensboro, NC 27408-5422

Phone

(336) 355-4554

NPI assigned

Nov 2, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Carlos Rodriguez DMD PLLC

  • General Practice Dentistry
  • Greensboro, NC
  • NPI 1942137278
  NPD (past)

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

{
    "created_epoch": "1604275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661212800000",
    "number": "1639770266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "477 GIBBS POND RD",
            "city": "NESCONSET",
            "state": "NY",
            "postal_code": "117672108",
            "telephone_number": "347-326-0440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2321 BATTLEGROUND AVE",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274085422",
            "telephone_number": "336-355-4554"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "760 Broadway Rm 10A218",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112065383",
            "country_code": "US",
            "telephone_number": "718-963-5765",
            "fax_number": "718-302-7832",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHAN",
        "first_name": "FAHAD",
        "middle_name": "GUL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-02",
        "last_updated": "2022-08-23",
        "certification_date": "2022-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "12990",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GK74054M",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lurline Keyser
• Keystone Youth Services, Inc.
• Sol Khaitas
• Billal Khaled
• Salman Ali Jehangir Khaliqdina, MBBS
• Farooque S.a. Khan, MD
• Ghalib Khan, MD
• Haakib Khan, PHARMD
• Ridwana Khan
• Salaar Rehman Khan, DDS

• General Practice Dentistry in Greensboro, NC
• Providers in Greensboro, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2022; 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.