Active NPI
Ali Mohammed Khan, DDS
- General Practice Dentistry
- Aurora, IL
National Provider Identifier
1689724684
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 019028018
- Practice address
- 3450 Montgomery Road, Unit 8
Aurora, IL 60504 - Phone
- (213) 253-5160
- Fax
- (213) 253-5158
- NPI assigned
- Jan 11, 2007
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 019028018 | IL | Primary |
Addresses
Primary practice location
3450 Montgomery Road, Unit 8
Aurora, IL 60504
Mailing address
3763 Monarch Circle
Naperville, IL 60564
Phone (213) 820-6487
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 |
|---|---|---|---|
| 019028018 | IL | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dental Smiles of Bolingbrook | Past | Accepting new patients | |
| Tranquil Dental | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Dental Clinic/Center
- Bolingbrook, IL
- NPI 1003425125
-
- Dental Clinic/Center
- Aurora, IL
- NPI 1891188488
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168473600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1416528000000",
"number": "1689724684",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3763 MONARCH CIRCLE",
"city": "NAPERVILLE",
"state": "IL",
"postal_code": "60564",
"telephone_number": "213-820-6487",
"fax_number": "213-749-1889"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3450 MONTGOMERY ROAD, UNIT 8",
"city": "AURORA",
"state": "IL",
"postal_code": "60504",
"telephone_number": "213-253-5160",
"fax_number": "213-253-5158"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHAN",
"first_name": "ALI",
"middle_name": "MOHAMMED",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-11",
"last_updated": "2014-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "IL",
"license": "019028018",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Aurora, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.