Provider Demographics
NPI:1356460828
Name:KHAN, SOHAIL (DMD)
Entity Type:Individual
Prefix:DR
First Name:SOHAIL
Middle Name:
Last Name:KHAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7009 DR PHILLIPS BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819-5123
Mailing Address - Country:US
Mailing Address - Phone:407-370-0200
Mailing Address - Fax:407-370-0277
Practice Address - Street 1:7009 DR PHILLIPS BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-5123
Practice Address - Country:US
Practice Address - Phone:407-370-0200
Practice Address - Fax:407-370-0277
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN165591223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice