Healthcare Provider Details

I. General information

NPI: 1699451617
Provider Name (Legal Business Name): KUMAIL ALIKHAN DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2023
Last Update Date: 03/14/2025
Certification Date: 03/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

77 JULIUSTOWN RD
BROWNS MILLS NJ
08015-3627
US

IV. Provider business mailing address

120 NEILSON ST APT 242
NEW BRUNSWICK NJ
08901-1456
US

V. Phone/Fax

Practice location:
  • Phone: 609-893-5200
  • Fax:
Mailing address:
  • Phone: 508-243-7820
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number22DI03080500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: