Provider Demographics
NPI:1477731537
Name:KHAN, JAMSHAID ASLAM (DDS)
Entity Type:Individual
Prefix:
First Name:JAMSHAID
Middle Name:ASLAM
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 1:900 BUGG LN
Mailing Address - Street 2:SUITE 218
Mailing Address - City:SAN MARCOS
Mailing Address - State:TX
Mailing Address - Zip Code:78666-8086
Mailing Address - Country:US
Mailing Address - Phone:740-803-0150
Mailing Address - Fax:
Practice Address - Street 1:900 BUGG LN
Practice Address - Street 2:SUITE 218
Practice Address - City:SAN MARCOS
Practice Address - State:TX
Practice Address - Zip Code:78666-8086
Practice Address - Country:US
Practice Address - Phone:740-803-0150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-31
Last Update Date:2008-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX236711223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice