MEDICARE: DR. WILLIAM KHANI D.M.D.

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
1	1223G0001X	General Practice Dentistry	032329	NY

Other Identifiers

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

General Provider Information

NPI Number	:	1750449575
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM KHANI D.M.D.

Provider Business Mailing Address
First Line	:	616 PIERMONT RD
Second Line	:
City	:	DEMAREST
State	:	NJ
Zip	:	07627-1114
Country	:	US
Telephone Number	:	201-784-3628
Fax Number	:	702-548-8527

Provider Business Practice Location Address
First Line	:	527 MARCY AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11206-5606
Country	:	US
Telephone Number	:	718-782-6230
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/05/2006
Last Update Date	:	07/08/2007

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