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General NPI Number Information
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NPI Number | 1013519701
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Entity Type | Individual
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Provider Name | SUNDAS KHAN DMD
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Gender | Female
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Dates
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Enumeration Date | 11/09/2020
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Last Update Date | 11/09/2020
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Provider Practice Location Address
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Address Line | 91 EAST AVE
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City | NORWALK
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State | CT
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Zip | 06851-5020
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Country | US
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Telephone | 203-299-0111
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Fax |
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Provider Business Mailing Address
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Address Line | 795 COLUMBUS AVE APT 9N
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City | NEW YORK
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State | NY
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Zip | 10025-5949
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Country | US
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Telephone | 516-754-5596
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 12960
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License Number State | CT
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