Active NPI
Henna A Khare, DDS
- Dentist
- Canton, MI
National Provider Identifier
1649808486
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2901601997
- Practice address
- 5970 N Lilley Rd
Canton, MI 48187-3625 - Phone
- (734) 224-5365
- NPI assigned
- Mar 28, 2020
- Last updated
- Dec 8, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 10575 | KY | |
| Dentist | 122300000X | D14629 | MN | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Dentist | 122300000X | 2901601997 | MI | Primary |
Addresses
Primary practice location
5970 N Lilley Rd
Canton, MI 48187-3625
Mailing address
5970 N Lilley Rd
Canton, MI 48187-3625
Phone (763) 528-0102
Other practice location 1
11300 Wayzata Blvd
Minnetonka, MN 55305-2019
Phone (952) 314-1125
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20211215000381 | IN | Order and Referring Only - Dentist | 8921499518 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10575 | KY | MD | Dentist |
| 2901601997 | MI | MD | Dentist |
| D14629 | MN | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1585353600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701993600000",
"number": "1649808486",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5970 N LILLEY RD",
"city": "CANTON",
"state": "MI",
"postal_code": "481873625",
"telephone_number": "763-528-0102"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5970 N LILLEY RD",
"city": "CANTON",
"state": "MI",
"postal_code": "481873625",
"telephone_number": "734-224-5365"
}
],
"practiceLocations": [
{
"address_1": "11300 Wayzata Blvd",
"address_purpose": "LOCATION",
"city": "Minnetonka",
"state": "MN",
"postal_code": "553052019",
"country_code": "US",
"telephone_number": "952-314-1125",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KHARE",
"first_name": "HENNA",
"middle_name": "A",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-03-28",
"last_updated": "2023-12-08",
"certification_date": "2023-11-28",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "KY",
"license": "10575",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MN",
"license": "D14629",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MI",
"license": "2901601997",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Canton, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.