Provider Demographics
NPI:1306166319
Name:KHAN, ZAINAB MUNAWER (DMD)
Entity type:Individual
Prefix:DR
First Name:ZAINAB
Middle Name:MUNAWER
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 1:1180 BURNHAM ST
Mailing Address - Street 2:
Mailing Address - City:CAROL STREAM
Mailing Address - State:IL
Mailing Address - Zip Code:60188-1393
Mailing Address - Country:US
Mailing Address - Phone:630-926-1494
Mailing Address - Fax:
Practice Address - Street 1:134 EVERGREEN RD
Practice Address - Street 2:STE 200
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40243-1487
Practice Address - Country:US
Practice Address - Phone:630-926-1494
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-02
Last Update Date:2014-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
KY93521223G0001X, 122300000X, 1223D0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No122300000XDental ProvidersDentist
No1223D0001XDental ProvidersDentistDental Public Health