MEDICARE: KHALID R JILANI DMD LIMITED

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	1223E0200X	Endodontics
2	1223P0300X	Periodontics
3	1223P0700X	Prosthodontics
4	1223S0112X	Oral and Maxillofacial Surgery (Dentist)
5	1223G0001X	General Practice Dentistry	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	:	1629426283
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KHALID R JILANI DMD LIMITED

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	:	GENERAL DENTIST/MANAGER
Name	:	DR. KHALID JILANI
Credential	:	DMD
Telephone Number	:	702-748-8244

Provider Enumeration Date	:	05/24/2016
Last Update Date	:	05/15/2023

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Directions to “KHALID R JILANI DMD LIMITED ” Practice Location

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