Individual provider Active NPI

Muna Nasreen Khan, DDS

  • Dentist
  • New York, NY
National Provider Identifier
1710040217
Registry record updated Aug 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
043368 Issued in NY
Practice address
139 Centre St Ste 316
New York, NY 10013-4554
Phone
(129) 410-0882
Fax
(212) 941-0188
NPI assigned
Dec 18, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NJ 21093 NJ
Dentist 122300000X 043368 NY Primary

Addresses

Primary practice location

139 Centre St Ste 316
New York, NY 10013-4554

Mailing address

139 Centre St Ste 316
New York, NY 10013-4554
Phone (212) 941-0088

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150319000362 NJ Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 3476870064

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
NJ 21093NJMDGeneral Practice Dentistry
043368NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
3CK Dentist, PLLC CurrentSince Jul 21, 2024 Accepting new patients

Locations

139 Centre St
Ste 316
New York, NY 10013
Phone (212) 941-0088

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723075200000",
    "number": "1710040217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "139 CENTRE ST STE 316",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100134554",
            "telephone_number": "212-941-0088",
            "fax_number": "212-941-0188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "139 CENTRE ST STE 316",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100134554",
            "telephone_number": "129-410-0882",
            "fax_number": "212-941-0188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "MUNA",
        "middle_name": "NASREEN",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-18",
        "last_updated": "2024-08-08",
        "certification_date": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "NJ 21093",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "043368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.