MEDICARE: DR. KHALID R JILANI DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	64416	CA
2	1223E0200X	Endodontics	6504	NV
3	1223P0300X	Periodontics	6504	NV
4	1223P0700X	Prosthodontics	6504	NV
5	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	6504	NV
6	122300000X	Dentist	6504	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1124431200
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KHALID R JILANI DMD

Provider Business Mailing Address
First Line	:	2668 LAS VEGAS BLVD N STE 101
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89030-5870
Country	:	US
Telephone Number	:	702-748-8244
Fax Number	:	702-997-1223

Provider Business Practice Location Address
First Line	:	2668 LAS VEGAS BLVD N STE 101
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89030-5870
Country	:	US
Telephone Number	:	702-748-8244
Fax Number	:	702-997-1223

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/06/2014
Last Update Date	:	06/12/2023

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Directions to “ DR. KHALID R JILANI DMD” Practice Location

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