Healthcare Provider Details

I. General information

NPI: 1396306692
Provider Name (Legal Business Name): SALWAN KHUDHUR DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2019
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8840 BLAKENEY PROFESSIONAL DRIVE STE 300
CHARLOTTE NC
28277
US

IV. Provider business mailing address

584 E BIG BEAVER RD APT 201
TROY MI
48083-1358
US

V. Phone/Fax

Practice location:
  • Phone: 704-716-9840
  • Fax: 704-716-9841
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number2901600208
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number14676
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number11389
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: