Provider Demographics
NPI:1437644283
Name:KHAN, ADIL (DMD)
Entity Type:Individual
Prefix:DR
First Name:ADIL
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 1:917 DUNKIRK LN
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76017-6560
Mailing Address - Country:US
Mailing Address - Phone:682-433-1348
Mailing Address - Fax:
Practice Address - Street 1:10909 WEBB CHAPEL RD STE 159
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75229-3739
Practice Address - Country:US
Practice Address - Phone:972-807-9887
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-25
Last Update Date:2018-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX341031223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice