MUJTABA KHAN (NPI# 1093260366) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093260366 |
| Entity Type | Individual |
| Full Name | MUJTABA KHAN |
| Practice Address |
1931 Main St Green Bay WI 54302-3920 |
| Mailing Address |
2345 Sunny Lane Apt P Green Bay WI 54313 |
| Practice Telephone | 9204992770 |
| Mailing Telephone | 3165739707 |
| Enumeration Date | 2016-08-16 |
| Last Update Date | 2017-01-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 1001454-15 | WI | Dental Providers |
| N | 122300000X | Dentist | 12012588A | IN | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629047857 | Mujtaba A. Khan | Internal Medicine | 7111 N Main St, Ste 50, Dayton, OH 45415-2558 | 2006-03-17 |
| Street Address |
1931 MAIN ST |
| City | GREEN BAY |
| State | WI |
| Zip Code | 54302-3920 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629448170 | Simerjeet Kaur | Dentist | 1931 Main St, Green Bay, WI 54302-3920 | 2015-09-28 |
| 1841800547 | Jungik Hong | Dentist | 1931 Main St, Green Bay, WI 54302-3920 | 2020-08-06 |
| 1740812197 | Joon Hyuk Kim | Dentist | 1931 Main St, Green Bay, WI 54302-3920 | 2020-02-04 |
| 1902458680 | Rebecca El-khoury | Dentist | 1931 Main St, Green Bay, WI 54302-3920 | 2019-07-12 |
| 1922669779 | Nidhi Nangia | Dentist | 1931 Main St, Green Bay, WI 54302-3920 | 2019-06-24 |
| 1568020238 | Ashley Jan | Dentist | 1931 Main St, Green Bay, WI 54302-3920 | 2019-05-29 |
| 1154870228 | Melissa Ann Yeager | Dental Hygienist | 1931 Main St, Green Bay, WI 54302-3920 | 2016-09-29 |
| 1437608502 | Amy Jean Schowalter | Dental Hygienist | 1931 Main St, Green Bay, WI 54302-3920 | 2016-09-29 |
| 1700334265 | Mihai Kiss | Dentist | 1931 Main St, Green Bay, WI 54302-3920 | 2016-09-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659721371 | Carissa Marie Sawicki | Counselor | 1234 Main Street, Suite 21, 3rd Floor, Green Bay, WI 54302 | 2016-06-14 |
| 1891181459 | Shannon Rae Mullins | Registered Nurse | 2254 Imperial Ln, Green Bay, WI 54302 | 2015-04-10 |
| 1346667045 | David Howard Jadin | Dentist | 1245 Main St, Green Bay, WI 54302 | 2014-03-20 |
| 1407003577 | Abby Baumgart | Counselor | 1234-21 Main St, Green Bay, WI 54302 | 2008-08-20 |
| 1447441779 | Muller Eyecare Associates Ltd | Optometrist | 1776 E Mason St, Green Bay, WI 54302 | 2007-08-01 |
| 1851385231 | Bornemann Nursing Home Inc | Skilled Nursing Facility | 226 Bornemann St, Green Bay, WI 54302 | 2005-08-31 |
| 1194188706 | Familia Dental Green Bay LLC | Dentist | 1931 Main St., Green Bay, WI 54302 | 2016-03-31 |
| 1255710125 | Kim Lawrence | Social Worker | 1234 Main St., St 21, 3rd Floor, Green Bay, WI 54302 | 2015-05-26 |
| 1255464533 | John Muller | Optometrist | 1776 E Mason St, Green Bay, WI 54302 | 2007-03-14 |
| 1851622005 | Michael Andrew Larkey | Social Worker | 815 Reber St, Green Bay, WI 54302-1116 | 2010-01-27 |
| Find all providers in zip 54302 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184240236 | Casey Nan Messer | Dentist | 2805 Libal St Ste B, Green Bay, WI 54301-2888 | 2020-06-24 |
| 1003460551 | Affordable Dentures & Implants - Green Bay, S.c. | Dentist | 1800-c W. Mason Street, Green Bay, WI 54303 | 2019-08-01 |
| 1275013641 | David Alan Pass | Dentist | 844 Willard Dr # A, Green Bay, WI 54304-5265 | 2018-08-15 |
| 1831691872 | Melanie Hammerbeck | Dentist | 1756 Cardinal Ln, Green Bay, WI 54313 | 2018-03-06 |
| 1114453024 | Juan Sebastian Munoz | Dentist | 709 S Oneida St Ste 6, Green Bay, WI 54304-2475 | 2017-05-11 |
| 1851844161 | Green Bay Family Dental LLC | Dentist | 2609 Development Dr., Green Bay, WI 54311 | 2016-08-03 |
| 1043663321 | Thuy Nguyen | Dentist | 331 N Broadway, Green Bay, WI 54303-2701 | 2016-07-21 |
| 1629448170 | Simerjeet Kaur | Dentist | 1931 Main St, Green Bay, WI 54302-3920 | 2015-09-28 |
| 1811307408 | Adam Pasono | Dentist | 2313 S Webster Ave, Green Bay, WI 54301-2159 | 2014-05-05 |
| 1972764553 | S. Patrick Maraka | Dentist | 2830 Curry Ct Ste 1, Green Bay, WI 54311-4877 | 2008-06-17 |
| Find all providers in GREEN BAY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.