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NPI Code Detail

MEDICARE: SONNY KHANNA DMD

MEDICARE: SONNY KHANNA DMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry000013-2NY
21223G0001XGeneral Practice DentistryDN19960MA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1306830971
Entity Type Code : Individual
Provider Name (Legal Business Name) : SONNY KHANNA DMD
Provider Business Mailing Address
First Line : 1070 SAINT JAMES AVE STE D
Second Line :
City : SPRINGFIELD
State : MA
Zip : 01104-1453
Country : US
Telephone Number : 413-737-5665
Fax Number : 413-737-5781
Provider Business Practice Location Address
First Line : 1070 SAINT JAMES AVE STE D
Second Line :
City : SPRINGFIELD
State : MA
Zip : 01104-1453
Country : US
Telephone Number : 413-737-5665
Fax Number : 413-737-5781
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/09/2005
Last Update Date : 07/21/2022

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Directions to “ SONNY KHANNA DMD” Practice Location

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