Healthcare Provider Details

I. General information

NPI: 1285548487
Provider Name (Legal Business Name): DENTISTS OF WESTGATE, LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5937 N 91ST AVENUE, SUITE 110
GLENDALE AZ
85305
US

IV. Provider business mailing address

PO BOX 660041
DALLAS TX
75266-0041
US

V. Phone/Fax

Practice location:
  • Phone: 480-245-4455
  • Fax: 480-646-4220
Mailing address:
  • Phone: 714-845-8890
  • Fax: 303-952-0892

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number StateNULL

VIII. Authorized Official

Name: MOHAMMED KHAKWANI
Title or Position: OWNER
Credential: DMD
Phone: 480-245-4455