Active NPI
Amber Imtiaz Khan, D.M.D
- Dentist
- Orlando, FL
National Provider Identifier
1740269570
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 319-015482
- Practice address
- 3924 Town Ctr Blvd
Apt 201
Orlando, FL 32837-6103 - Phone
- (407) 240-1500
- Fax
- (407) 240-6922
- NPI assigned
- Jan 11, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 319-015482 | IL | Primary |
Addresses
Primary practice location
3924 Town Ctr Blvd
Apt 201
Orlando, FL 32837-6103
Mailing address
3924 Town Ctr Blvd
Apt 201
Orlando, FL 32837-6103
Phone (407) 240-1500
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- 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 |
|---|---|---|---|---|
| I20230516000351 | FL | Practitioner - Dentist | 0648578245 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 319-015482 | IL | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136937600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1459382400000",
"number": "1740269570",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3924 TOWN CTR BLVD",
"address_2": "APT 201",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328376103",
"telephone_number": "407-240-1500",
"fax_number": "407-240-6922"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3924 TOWN CTR BLVD",
"address_2": "APT 201",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328376103",
"telephone_number": "407-240-1500",
"fax_number": "407-240-6922"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHAN",
"first_name": "AMBER",
"middle_name": "IMTIAZ",
"credential": "D.M.D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-01-11",
"last_updated": "2016-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": "319-015482",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orlando, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2016; 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.