Provider Demographics
NPI:1093907289
Name:KHAN, NABEEL (DDS)
Entity Type:Individual
Prefix:DR
First Name:NABEEL
Middle Name:
Last Name:KHAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9554 OLD KEENE MILL RD STE C
Mailing Address - Street 2:
Mailing Address - City:BURKE
Mailing Address - State:VA
Mailing Address - Zip Code:22015-4287
Mailing Address - Country:US
Mailing Address - Phone:703-440-5075
Mailing Address - Fax:703-440-5076
Practice Address - Street 1:9554 OLD KEENE MILL RD STE C
Practice Address - Street 2:
Practice Address - City:BURKE
Practice Address - State:VA
Practice Address - Zip Code:22015-4287
Practice Address - Country:US
Practice Address - Phone:703-440-5075
Practice Address - Fax:703-440-5076
Is Sole Proprietor?:No
Enumeration Date:2007-08-13
Last Update Date:2007-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401410874122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist