MEDICARE: DAVID KHAYATA 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	DS045699	PA

General Provider Information

NPI Number	:	1336070135
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID KHAYATA DMD

Provider Business Mailing Address
First Line	:	1590 ALTA DR APT D22
Second Line	:
City	:	WHITEHALL
State	:	PA
Zip	:	18052-5628
Country	:	US
Telephone Number	:	610-417-0294
Fax Number	:

Provider Business Practice Location Address
First Line	:	4727 FREEMANSBURG AVE STE 104
Second Line	:
City	:	EASTON
State	:	PA
Zip	:	18045-5529
Country	:	US
Telephone Number	:	610-550-8584
Fax Number	:

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

Provider Enumeration Date	:	05/28/2026
Last Update Date	:	05/28/2026

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