Shakeel Anwar Khan, DDS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

7982 Issued in NE

Practice address

12242 K PLZ Ste 113
Omaha, NE 68137-2259

Phone

(402) 334-8083

NPI assigned

Sep 29, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

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.

• Metro West Dental Specialty Group

  • Periodontics
  • La Vista, NE
  • NPI 1215647805
  NPD (past)
• Specialty Dental Care PC

  • Periodontics
  • Omaha, NE
  • NPI 1588781306
  NPD (past)

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

{
    "created_epoch": "1695945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1891575700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 S 208TH ST",
            "city": "ELKHORN",
            "state": "NE",
            "postal_code": "680221810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12242 K PLZ STE 113",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681372259",
            "telephone_number": "402-334-8083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "SHAKEEL",
        "middle_name": "ANWAR",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-09-29",
        "last_updated": "2023-11-27",
        "certification_date": "2023-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "FL",
            "license": "DN28570",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NE",
            "license": "7982",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Muhammad Farid Khan, M.D.
• Pasarlay Khan
• Robin Renee Khan, D.D.S.
• Saad Ali Khan, MD
• Sahar Saba Khan
• Shariq Khan
• Suboohi Khan, DO
• Terri A Khan, ARNP
• Umair Usman Khan, MD
• Birgit N Khandalavala, M.D.

• Periodontics in Omaha, NE
• Providers in Omaha, NE by specialty
• Periodontics in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; 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.