Provider Demographics
NPI:1467127092
Name:MOHAMMED, JUNED ALI KHAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:JUNED ALI KHAN
Middle Name:
Last Name:MOHAMMED
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 1:6160 S CASS AVE STE E
Mailing Address - Street 2:
Mailing Address - City:WESTMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60559-2685
Mailing Address - Country:US
Mailing Address - Phone:872-806-9602
Mailing Address - Fax:
Practice Address - Street 1:6160 S CASS AVE STE E
Practice Address - Street 2:
Practice Address - City:WESTMONT
Practice Address - State:IL
Practice Address - Zip Code:60559-2685
Practice Address - Country:US
Practice Address - Phone:630-812-7755
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-16
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.033230122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist