Mark I Khaimov is a Periodontics in Nutley, New Jersey. Mark I Khaimov practices all healthcare services and medical treatments related to Periodontics. The NPI Number for Mark I Khaimov is 1477614162. The last update date is 2016-07-18.
Mark I Khaimov's current location address is 180 Centre St, Nutley, New Jersey. You can contact this provider via phone number 9737982639 and fax number 9737982640. The mailing address for Mark I Khaimov is 180 Centre St, Nutley, New Jersey. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Mark I Khaimov |
|---|---|
| Address | 180 Centre St, Nutley, New Jersey |
| Phone Number | 9737982639 |
| Fax Number | 9737982640 |
| Sole Proprietor | Y |
| Credentials | DDS |
NPI Number Detail
| NPI Number | 1477614162 |
|---|---|
| Provider Enumeration Date | 2006-12-13 |
| Last Updated Date | 2016-07-18 |
Provider Mailing Address Detail
| Address | 180 Centre St |
|---|---|
| City | Nutley |
| State | New Jersey (NJ) |
| Post Code | 71102828 |
| Phone Number | 9737982639 |
| Fax Number | 9737982640 |
Provider's Primary Taxonomy Detail
| Speciality | Periodontics |
|---|---|
| Taxonomy | 1223P0300X |
| Licence No | 2249201 |
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Definition: That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structure |
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Post Comment/ Review Below
What is the unique 10-digit identification code assigned to Mark I Khaimov by the Centers for Medicare & Medicaid Services?
The Mark I Khaimov has been issued the NPI (National Provider Identifier) 1477614162, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you please provide the complete physical location address of Mark I Khaimov?
The Mark I Khaimov is physically situated at 180 Centre St, in the city of Nutley, state of NJ, with the postal code 71102828.
What is Mark I Khaimov's area of specialization, and what is the corresponding taxonomy classification code for this field of practice?
The specialized area of practice for Mark I Khaimov is Periodontics, and the taxonomy code that categorizes this field of expertise is 1223P0300X.
On what date did the Mark I Khaimov receive its 1477614162 assignment from the Centers for Medicare & Medicaid Services?
The Mark I Khaimov was assigned its 1477614162 by the Centers for Medicare & Medicaid Services on 2006-12-13.
As of what date were the Mark I Khaimov's details last updated?
The information pertaining to the Mark I Khaimov, including its address, specialty, and other details, was most recently updated on 2016-07-18.