Provider Demographics
NPI:1336306265
Name:KHANDJI, MAHER
Entity Type:Individual
Prefix:
First Name:MAHER
Middle Name:
Last Name:KHANDJI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 WASHINGTON RD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15228-1901
Mailing Address - Country:US
Mailing Address - Phone:412-343-5515
Mailing Address - Fax:412-343-6618
Practice Address - Street 1:615 WASHINGTON RD
Practice Address - Street 2:SUITE 205
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15228-1901
Practice Address - Country:US
Practice Address - Phone:412-343-5515
Practice Address - Fax:412-343-6618
Is Sole Proprietor?:No
Enumeration Date:2008-05-19
Last Update Date:2013-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS029260L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist