Provider Demographics
NPI:1083585525
Name:MD IBRAHIM KHALIL DDS PC
Entity type:Organization
Organization Name:MD IBRAHIM KHALIL DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:MD
Authorized Official - Middle Name:IBRAHIM
Authorized Official - Last Name:KHALIL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:646-897-8389
Mailing Address - Street 1:7275 E SOUTHGATE DR
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95823-2628
Mailing Address - Country:US
Mailing Address - Phone:646-897-8389
Mailing Address - Fax:
Practice Address - Street 1:7275 E SOUTHGATE DR
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95823-2628
Practice Address - Country:US
Practice Address - Phone:646-897-8389
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-17
Last Update Date:2025-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty