Provider Demographics
NPI:1578655916
Name:KHAN, ASAAD SAEED (DDS)
Entity Type:Individual
Prefix:DR
First Name:ASAAD
Middle Name:SAEED
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 1:15990 S RANCHO SAHUARITA BLVD STE 110
Mailing Address - Street 2:
Mailing Address - City:SAHUARITA
Mailing Address - State:AZ
Mailing Address - Zip Code:85629-8022
Mailing Address - Country:US
Mailing Address - Phone:513-850-2051
Mailing Address - Fax:
Practice Address - Street 1:6600 N ORACLE RD
Practice Address - Street 2:SUITE NUMBER 110
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-5676
Practice Address - Country:US
Practice Address - Phone:614-746-9012
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-29
Last Update Date:2017-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV37011223G0001X
AZD07954122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810005771Medicaid
AZ552228Medicaid