Tasadaq Khan Khakwani, D.D.S

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

058753 Issued in NY

Practice address

4980 175TH PL
Fresh Meadows, NY 11365-1624

Phone

(551) 655-8955

NPI assigned

Jul 31, 2015

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

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

{
    "created_epoch": "1438300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470700800000",
    "number": "1972989952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20614 EMILY RD",
            "address_2": "#42M",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113601181",
            "telephone_number": "551-655-8955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4980 175TH PL",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113651624",
            "telephone_number": "551-655-8955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAKWANI",
        "first_name": "TASADAQ",
        "middle_name": "KHAN",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-07-31",
        "last_updated": "2016-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "058753",
            "primary": true
        },
        {
            "code": "261QS1000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Student Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kesef Pharmacy,Inc.
• Kew Gardens Sep Inc.
• Joseph Ariel Khafi, DDS
• Daniel Khaimov, M.D.
• Yuriy Khaimov, P.T
• Ulyana Khaldarov, MD
• Ishtiaque A Khan
• Minakshi Khanna, PA
• Sarita Khatri, MD
• Mosammat Shahanara Khatun, RN

• General Practice Dentistry in Fresh Meadows, NY
• Providers in Fresh Meadows, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2016; 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.