Provider Demographics
NPI:1023245909
Name:KHAMBATY, SAKINA QAYYUM (DMD)
Entity type:Individual
Prefix:DR
First Name:SAKINA
Middle Name:QAYYUM
Last Name:KHAMBATY
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 1:510 RANCH TRL STE 102
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75063-4880
Mailing Address - Country:US
Mailing Address - Phone:972-597-2227
Mailing Address - Fax:972-597-2225
Practice Address - Street 1:510 RANCH TRL STE 102
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75063-4880
Practice Address - Country:US
Practice Address - Phone:972-597-2227
Practice Address - Fax:972-597-2225
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-17
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN18689122300000X
IL019.028499122300000X
TX297311223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist