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NPI Code Detail

MEDICARE: BUSHRA TAHIR KHAN

MEDICARE: BUSHRA TAHIR KHAN
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
1122300000XDentist2026024258MO

General Provider Information

NPI Number : 1518729938
Entity Type Code : Individual
Provider Name (Legal Business Name) : BUSHRA TAHIR KHAN
Provider Business Mailing Address
First Line : 355 WATFORD DR APT A
Second Line :
City : BALLWIN
State : MO
Zip : 63011-3784
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 615 S NEW BALLAS RD
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63141-8221
Country : US
Telephone Number : 314-251-6930
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/30/2024
Last Update Date : 06/05/2026

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Directions to “ BUSHRA TAHIR KHAN ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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