Individual provider Active NPI

Amna Khan, DDS

  • General Practice Dentistry
  • Simi Valley, CA
National Provider Identifier
1902082381
Registry record updated Jan 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
52621 Issued in CA
Practice address
5406 Evening Sky Dr
Simi Valley, CA 93063-5745
Phone
(213) 446-8667
NPI assigned
Jan 15, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 52621 CA Primary

Addresses

Primary practice location

5406 Evening Sky Dr
Simi Valley, CA 93063-5745

Mailing address

5406 Evening Sky Dr
Simi Valley, CA 93063-5745
Phone (213) 446-8667

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150909000299 CA Order and Referring Only - Other (Non-Physician) 9335455294

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
52621CAMDMarriage & Family Therapist

Interoperability endpoints

  • Direct secure messaging: akhan@direct.westerndental.com

NPI Registry JSON

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

{
    "created_epoch": "1200355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200355200000",
    "number": "1902082381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5406 EVENING SKY DR",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930635745",
            "telephone_number": "213-446-8667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5406 EVENING SKY DR",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930635745",
            "telephone_number": "213-446-8667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "AMNA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-15",
        "last_updated": "2008-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "52621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Simi Valley, CA

Sources for this page

Verify at the official NPI Registry.