Healthcare Provider Details

I. General information

NPI: 1689122988
Provider Name (Legal Business Name): JUNAD KHAN BDS, MDS, MPH, PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2016
Last Update Date: 06/29/2023
Certification Date: 03/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UNIVERSITY OF ROCHESTER 601 ELMWOOD AVE
ROCHESTER NY
14642
US

IV. Provider business mailing address

2400 S CLINTON AVE STE 125
ROCHESTER NY
14618-2668
US

V. Phone/Fax

Practice location:
  • Phone: 585-784-8200
  • Fax: 585-784-8207
Mailing address:
  • Phone: 585-341-7316
  • Fax: 585-341-7320

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number000080
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code1223X2210X
TaxonomyOrofacial Pain Dentistry
License Number80
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code1223X2210X
TaxonomyOrofacial Pain Dentistry
License Number000080
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: