Individual provider Active NPI

Naser A Khan, DMD

  • General Practice Dentistry
  • Columbus, OH
National Provider Identifier
1780105320
Registry record updated May 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
30.025587 Issued in OH
Practice address
1501 Hilliard Rome Rd
Columbus, OH 43228-9544
Phone
(614) 429-5179
NPI assigned
Jul 5, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 28, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X MI
General Practice Dentistry 1223G0001X 30.025587 OH Primary

Addresses

Primary practice location

1501 Hilliard Rome Rd
Columbus, OH 43228-9544

Mailing address

4900 Milan Rd
Sandusky, OH 44870-5842
Phone (630) 379-2030

Other practice location 1

2900 N Saginaw St
Flint, MI 48505-4452
Phone (810) 406-4246

Other practice location 2

4900 Milan Rd
Sandusky, OH 44870
Phone (630) 379-2030

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20201210000900 OH Practitioner - Dentist 0840602165 Practice locations: Port Clinton, OH

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30.025587OHMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Catawba Dental Past Accepting new patients

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": "1499212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716854400000",
    "number": "1780105320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4900 MILAN RD",
            "city": "SANDUSKY",
            "state": "OH",
            "postal_code": "448705842",
            "telephone_number": "630-379-2030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 HILLIARD ROME RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432289544",
            "telephone_number": "614-429-5179"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2900 N Saginaw St",
            "address_purpose": "LOCATION",
            "city": "Flint",
            "state": "MI",
            "postal_code": "485054452",
            "country_code": "US",
            "telephone_number": "810-406-4246",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4900 Milan Rd",
            "address_purpose": "LOCATION",
            "city": "Sandusky",
            "state": "OH",
            "postal_code": "44870",
            "country_code": "US",
            "telephone_number": "630-379-2030",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHAN",
        "first_name": "NASER",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-07-05",
        "last_updated": "2024-05-28",
        "certification_date": "2024-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30.025587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.