Provider Demographics
NPI:1811737950
Name:KHAN, MAHAM MASUD (BDS)
Entity type:Individual
Prefix:DR
First Name:MAHAM
Middle Name:MASUD
Last Name:KHAN
Suffix:
Gender:F
Credentials:BDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:475 K ST NW UNIT 1126
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20001-5273
Mailing Address - Country:US
Mailing Address - Phone:917-318-2629
Mailing Address - Fax:
Practice Address - Street 1:600 W ST NW # 2005
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20059-1022
Practice Address - Country:US
Practice Address - Phone:202-806-6100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-28
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014187661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice