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General NPI Number Information
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NPI Number | 1689724684
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Entity Type | Individual
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Provider Name | ALI MOHAMMED KHAN DDS
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Gender | Male
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Dates
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Enumeration Date | 01/11/2007
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Last Update Date | 11/21/2014
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Provider Practice Location Address
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Address Line | 3450 MONTGOMERY ROAD, UNIT 8
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City | AURORA
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State | IL
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Zip | 60504
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Country | US
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Telephone | 213-253-5160
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Fax | 213-253-5158
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Provider Business Mailing Address
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Address Line | 3763 MONARCH CIRCLE
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City | NAPERVILLE
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State | IL
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Zip | 60564
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Country | US
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Telephone | 213-820-6487
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Fax | 213-749-1889
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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 | 019028018
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License Number State | IL
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