Provider Demographics
NPI:1902520463
Name:KHAN, NEHA (DMD)
Entity Type:Individual
Prefix:DR
First Name:NEHA
Middle Name:
Last Name:KHAN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4411 SW 34TH ST APT 1002
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32608-2565
Mailing Address - Country:US
Mailing Address - Phone:954-263-8203
Mailing Address - Fax:
Practice Address - Street 1:4631 NW BLITCHTON RD
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34482-4020
Practice Address - Country:US
Practice Address - Phone:352-619-9414
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-28
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN272551223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice