Provider Demographics
NPI:1740619089
Name:KHAN, MUHAMMAD ADNAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:MUHAMMAD
Middle Name:ADNAN
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 1:5303 PLAZA DR STE 103
Mailing Address - Street 2:
Mailing Address - City:HOPEWELL
Mailing Address - State:VA
Mailing Address - Zip Code:23860-7331
Mailing Address - Country:US
Mailing Address - Phone:804-458-5047
Mailing Address - Fax:804-458-6113
Practice Address - Street 1:5303 PLAZA DR STE 103
Practice Address - Street 2:
Practice Address - City:HOPEWELL
Practice Address - State:VA
Practice Address - Zip Code:23860-7331
Practice Address - Country:US
Practice Address - Phone:804-458-5047
Practice Address - Fax:044-586-1138
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-07
Last Update Date:2020-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401415832122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist