Healthcare Provider Details

I. General information

NPI: 1811828452
Provider Name (Legal Business Name): DR. KHUSHI DHAWAN
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2026
Last Update Date: 05/25/2026
Certification Date: 05/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

198 THOMAS JOHNSON DR
FREDERICK MD
21702-4398
US

IV. Provider business mailing address

11613 TALL PINES DR
GERMANTOWN MD
20876-4318
US

V. Phone/Fax

Practice location:
  • Phone: 301-835-1010
  • Fax:
Mailing address:
  • Phone: 240-507-2692
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number18662
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: