Provider Demographics
NPI:1922629500
Name:KHAN, TALIAH JAMSHED (DMD)
Entity type:Individual
Prefix:DR
First Name:TALIAH
Middle Name:JAMSHED
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 1:248 COLUMBIA TPKE
Mailing Address - Street 2:
Mailing Address - City:FLORHAM PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07932-1210
Mailing Address - Country:US
Mailing Address - Phone:973-377-0224
Mailing Address - Fax:973-377-7731
Practice Address - Street 1:248 COLUMBIA TPKE
Practice Address - Street 2:
Practice Address - City:FLORHAM PARK
Practice Address - State:NJ
Practice Address - Zip Code:07932-1210
Practice Address - Country:US
Practice Address - Phone:973-377-0224
Practice Address - Fax:973-377-7731
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-05
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI028031001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice