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General NPI Number Information
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NPI Number | 1699091579
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Entity Type | Individual
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Provider Name | ASMA KHAN DDS
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Gender | Female
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Dates
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Enumeration Date | 04/16/2010
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Last Update Date | 04/21/2025
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Provider Practice Location Address
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Address Line | 155 TRADERS WAY STE 400
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City | POOLER
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State | GA
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Zip | 31322-4300
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Country | US
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Telephone | 912-913-0467
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Fax |
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Provider Business Mailing Address
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Address Line | 190 WOOD HAVEN LN
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City | POOLER
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State | GA
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Zip | 31322-9776
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Country | US
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Telephone | 646-234-1530
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN123520
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License Number State | GA
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