Mahtab Khoshkhou, DDS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

13750 Issued in MD

Practice address

8531 Veterans Hwy Ste 103
Millersville, MD 21108-2653

Phone

(410) 987-2273

Fax

(443) 782-0367

NPI assigned

Jun 18, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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 and National Provider Directory roles.

• Arundel Pediatric Dental Care

  • Pediatric Dentistry
  • Millersville, MD
  • NPI 1720562507
  NPD Authorized official

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

{
    "created_epoch": "1182124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695254400000",
    "number": "1669677852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8531 VETERANS HWY STE 103",
            "city": "MILLERSVILLE",
            "state": "MD",
            "postal_code": "211082653",
            "telephone_number": "410-987-2273",
            "fax_number": "443-782-0367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8531 VETERANS HWY STE 103",
            "city": "MILLERSVILLE",
            "state": "MD",
            "postal_code": "211082653",
            "telephone_number": "410-987-2273",
            "fax_number": "443-782-0367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHOSHKHOU",
        "first_name": "MAHTAB",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-18",
        "last_updated": "2023-09-21",
        "certification_date": "2023-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MD",
            "license": "13750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chang-Wuk Kang, MD
• Sammy S.W. Kang, MD
• Kristy Keck, L.M.T.
• Shareese Nichole Kess, LCSW-C, CCM
• Stephanie Mary Kestler, LCSW-C
• Shatera Kimbrough
• Knollwood Manor, Inc
• Candice M Kordish, LCPC
• Laura Kort, LGPC
• Corrine Krampf, OTL

• Pediatric Dentistry in Millersville, MD
• Providers in Millersville, MD by specialty
• Pediatric Dentistry in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 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.