Provider Demographics
NPI:1053549485
Name:KHAN, ADEEL U (DDS)
Entity type:Individual
Prefix:DR
First Name:ADEEL
Middle Name:U
Last Name:KHAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3070 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43701-1409
Mailing Address - Country:US
Mailing Address - Phone:740-454-9961
Mailing Address - Fax:412-784-0458
Practice Address - Street 1:3070 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-1409
Practice Address - Country:US
Practice Address - Phone:740-454-9961
Practice Address - Fax:740-454-1670
Is Sole Proprietor?:No
Enumeration Date:2009-06-24
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS037943122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist