Provider Demographics
NPI:1316194475
Name:KHAN, NEESHAT SOHAIL (DDS)
Entity Type:Individual
Prefix:DR
First Name:NEESHAT
Middle Name:SOHAIL
Last Name:KHAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21672 GRANADA AVE
Mailing Address - Street 2:
Mailing Address - City:CUPERTINO
Mailing Address - State:CA
Mailing Address - Zip Code:95014-5928
Mailing Address - Country:US
Mailing Address - Phone:408-777-1290
Mailing Address - Fax:408-777-1293
Practice Address - Street 1:21672 GRANADA AVE
Practice Address - Street 2:
Practice Address - City:CUPERTINO
Practice Address - State:CA
Practice Address - Zip Code:95014-5928
Practice Address - Country:US
Practice Address - Phone:408-777-1290
Practice Address - Fax:408-777-1293
Is Sole Proprietor?:No
Enumeration Date:2008-08-20
Last Update Date:2010-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA574781223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice