Provider Demographics
NPI:1811366214
Name:KHAN, FARHAN (DMD)
Entity Type:Individual
Prefix:DR
First Name:FARHAN
Middle Name:
Last Name:KHAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:715 E ROLLING VIEW DR
Mailing Address - Street 2:
Mailing Address - City:PARK CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67147-7305
Mailing Address - Country:US
Mailing Address - Phone:857-200-9310
Mailing Address - Fax:
Practice Address - Street 1:3882 S CLACK ST
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79606-2711
Practice Address - Country:US
Practice Address - Phone:325-307-7730
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-16
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS61316122300000X, 1223G0001X
TX31437122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist