Active NPI
Hilal Khan Ahmad, DDS
- Dentist
- Puyllup, WA
National Provider Identifier
1902005408
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 5778
- Practice address
- 11012 Canyon Rd East
Suite 40
Puyllup, WA 98373 - Phone
- (253) 531-1900
- Fax
- (253) 859-0799
- NPI assigned
- Jul 13, 2007
- Sex
- Male
- 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 | 5778 | WA | Primary |
Addresses
Primary practice location
11012 Canyon Rd East
Suite 40
Puyllup, WA 98373
Mailing address
10024 SE 240 St
Suite 101
Kent, WA 98031
Phone (253) 859-6000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5778 | WA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184284800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1685404800000",
"number": "1902005408",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10024 SE 240 ST",
"address_2": "SUITE 101",
"city": "KENT",
"state": "WA",
"postal_code": "98031",
"telephone_number": "253-859-6000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11012 CANYON RD EAST",
"address_2": "SUITE 40",
"city": "PUYLLUP",
"state": "WA",
"postal_code": "98373",
"telephone_number": "253-531-1900",
"fax_number": "253-859-0799"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AHMAD",
"first_name": "HILAL",
"middle_name": "KHAN",
"name_prefix": "Mr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-07-13",
"last_updated": "2023-05-30",
"certification_date": "2023-05-30",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WA",
"license": "5778",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 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.