Provider Demographics
NPI:1649622259
Name:IRFAN AZIZ KHAN, INC
Entity type:Organization
Organization Name:IRFAN AZIZ KHAN, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:IRFAN
Authorized Official - Middle Name:AZIZ
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:614-505-7027
Mailing Address - Street 1:2023 POLARIS PKWY
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43240-2000
Mailing Address - Country:US
Mailing Address - Phone:614-505-7027
Mailing Address - Fax:
Practice Address - Street 1:2023 POLARIS PKWY
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43240-2000
Practice Address - Country:US
Practice Address - Phone:614-505-7027
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-07
Last Update Date:2016-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty