MEDICARE: DR. UZMA KHAN DDS

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	050617	NY

General Provider Information

NPI Number	:	1497845853
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. UZMA KHAN DDS

Provider Business Mailing Address
First Line	:	6416 11TH AVE
Second Line	:	SUITE 1
City	:	BROOKLYN
State	:	NY
Zip	:	11219-5639
Country	:	US
Telephone Number	:	718-833-4373
Fax Number	:

Provider Business Practice Location Address
First Line	:	6416 11TH AVE
Second Line	:	SUITE 1
City	:	BROOKLYN
State	:	NY
Zip	:	11219-5639
Country	:	US
Telephone Number	:	718-833-4373
Fax Number	:

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

Provider Enumeration Date	:	10/13/2006
Last Update Date	:	06/01/2015

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