Provider Demographics
NPI:1578758272
Name:KHAN, AATIFA KALIM (DDS)
Entity Type:Individual
Prefix:DR
First Name:AATIFA
Middle Name:KALIM
Last Name:KHAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2905 MITCHELLVILLE RD
Mailing Address - Street 2:STE 108
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20716-1385
Mailing Address - Country:US
Mailing Address - Phone:301-249-1571
Mailing Address - Fax:
Practice Address - Street 1:2905 MITCHELLVILLE RD STE 109
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20716-3956
Practice Address - Country:US
Practice Address - Phone:301-249-1571
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-06
Last Update Date:2020-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD14105122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist