Healthcare Provider Details

I. General information

NPI: 1619888153
Provider Name (Legal Business Name): ZARJAN KHAN DENTAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9700 BUSINESS PARK DR STE 400A
SACRAMENTO CA
95827-1718
US

IV. Provider business mailing address

7025 FORAKER DR
STOCKTON CA
95219-7021
US

V. Phone/Fax

Practice location:
  • Phone: 916-400-3552
  • Fax:
Mailing address:
  • Phone: 209-922-5302
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: ZARJAN KHAN
Title or Position: OWNER
Credential: DDS
Phone: 209-922-5302