Provider Demographics
NPI:1790215275
Name:KHAN, ZAINEB ATA (DDS)
Entity Type:Individual
Prefix:
First Name:ZAINEB
Middle Name:ATA
Last Name:KHAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:ZAINEB
Other - Middle Name:
Other - Last Name:ATA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6425 OLD PLANK RD STE 102
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27265-3277
Mailing Address - Country:US
Mailing Address - Phone:336-886-1747
Mailing Address - Fax:
Practice Address - Street 1:6425 OLD PLANK RD STE 102
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27265-3277
Practice Address - Country:US
Practice Address - Phone:336-886-1747
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-15
Last Update Date:2017-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10682122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist