Provider Demographics
NPI:1821776535
Name:KHIYANI, MUHAMMAD FAHEEM
Entity type:Individual
Prefix:MR
First Name:MUHAMMAD FAHEEM
Middle Name:
Last Name:KHIYANI
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 1:4098 BIG CREEK OVERLOOK
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30005-4212
Mailing Address - Country:US
Mailing Address - Phone:640-204-5153
Mailing Address - Fax:
Practice Address - Street 1:1549 WHITE MOUNTAIN HIGHWAY
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:NH
Practice Address - Zip Code:03860
Practice Address - Country:US
Practice Address - Phone:603-227-4507
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-11
Last Update Date:2024-10-20
Deactivation Date:2024-02-16
Deactivation Code:
Reactivation Date:2024-06-17
Provider Licenses
StateLicense IDTaxonomies
NH051241223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice