Provider Demographics
NPI:1902520463
Name:KHAN, NEHA (DMD)
Entity type:Individual
Prefix:DR
First Name:NEHA
Middle Name:
Last Name:KHAN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:NEHA
Other - Middle Name:KHAN
Other - Last Name:LATTY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD
Mailing Address - Street 1:461 RAILROAD AVE APT 212
Mailing Address - Street 2:
Mailing Address - City:WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11590-5036
Mailing Address - Country:US
Mailing Address - Phone:954-263-8203
Mailing Address - Fax:
Practice Address - Street 1:3131 LONG BEACH RD
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:NY
Practice Address - Zip Code:11572-4107
Practice Address - Country:US
Practice Address - Phone:516-548-7397
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-28
Last Update Date:2025-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN272551223G0001X
NY0643291223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice