Shazmeena Khattak, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN29239 Issued in FL

Practice address

4620 S Florida Ave Ste 120
Lakeland, FL 33813-2166

Phone

(863) 216-5765

NPI assigned

Jul 8, 2024

Sex

Female

Sole proprietor

No

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

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.

• Lakeland Modern Dentistry, PA

  • Dentist
  • Lakeland, FL
  • NPI 1235649518
  NPD (past)

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

{
    "created_epoch": "1720396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720396800000",
    "number": "1891531083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "616 PRIMROSE WILLOW WAY",
            "city": "APOPKA",
            "state": "FL",
            "postal_code": "327123031",
            "telephone_number": "850-257-4982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4620 S FLORIDA AVE STE 120",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338132166",
            "telephone_number": "863-216-5765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHATTAK",
        "first_name": "SHAZMEENA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-08",
        "last_updated": "2024-07-08",
        "certification_date": "2024-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN29239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zahraa Khan, M.S.
• Zoya Khan, DO
• Sarina Khanal, MD
• Aqeel Khanani
• Avinash Khanna, MD
• Saeed Khayyami
• Yatin Kheti, MD
• Sandy Khin, M.D
• Daniel Khokhar, DO
• Amrit Khooblall, MD

• General Practice Dentistry in Lakeland, FL
• Providers in Lakeland, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2024; 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.