Provider Demographics
NPI:1932678182
Name:KHAN, TONIMA (DDS)
Entity Type:Individual
Prefix:MS
First Name:TONIMA
Middle Name:
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 1:350 N CLARK ST.
Mailing Address - Street 2:STE 600
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60654
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:351 LOUCKS RD
Practice Address - Street 2:351 LOUCKS RD, STE E4
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17404
Practice Address - Country:US
Practice Address - Phone:717-848-3600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-16
Last Update Date:2018-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0420001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice