Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1164424016 Individual Practitioner Male Practitioner

Dr. Mahamid Ali Khan , DMD

Dentist • Berwyn, IL

Professional Overview & Biography Verified Profile Summary

Dr. Mahamid Khan, DMD is a registered healthcare professional specializing in Dentist in Berwyn, IL. Practice services are available at 6447 CERMAK RD under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

6447 Cermak Rd

Berwyn, IL 604022311

Telephone 7732541400
Fax 3128296375
Associated Practice Facility / Clinic
🏢 Alivio Medical Center Inc Facility NPI 1255646857

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist in Berwyn, IL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 12.1 Yrs
Regional Practice Density
27 Specialists

Practicing in Berwyn, IL (4751 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2021-07-02
Dentist Primary Specialty

NUCC Taxonomy Code: 122300000X

State License IL 019024670

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

Dentist

NUCC Taxonomy Code: 122300000X

State License MO 2005002250

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
019024670 (IL)
Medicaid State Provider ID
407262500 (MO)

Secondary Practice Locations

5701 Delmar Blvd

Saint Louis, MO 631122617

Phone: 3143677848

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Kaelyn Carroll , RN, CNM

Advanced Practice Midwife

NPI 1003706912

Registered Nurse, Certified Nurse Midwife

NPI 1003938762

Doctor of Medicine (M.D.)

Jacqueline Ma , CNM

Advanced Practice Midwife

NPI 1013422260

Certified Nurse Midwife

Dr. Roger Salazar , DMD

Dentist - Dental Public Health

NPI 1023792058

Doctor of Dental Medicine

Irma Correa , NP

Nurse Practitioner - Women's Health

NPI 1083218952

Nurse Practitioner

NPI 1124053269

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

9 Historical Events
📍
Updated Practice Location July 02, 2021

Registered at 6447 CERMAK RD, BERWYN, IL 604022311 (Tel: 7732541400)

📍
Updated Business Mailing Address July 02, 2021

Registered at 966 W 21ST ST, CHICAGO, IL 606084511 (Tel: 7732541400)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 02, 2021

Dentist (License #019024670 in IL)

NPI Profile Active February 07, 2013

NPI status registered as active in NPPES database

📍
Updated Practice Location February 07, 2013

Registered at 5701 DELMAR BLVD, SAINT LOUIS, MO 631122617 (Tel: 3143677848)

📍
Updated Business Mailing Address February 07, 2013

Registered at 5701 DELMAR BLVD, SAINT LOUIS, MO 631122617 (Tel: 3143677848)

👤
Provider Name / Credentials Updated February 07, 2013

Recorded as MAHAMID KHAN, DMD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) February 07, 2013

Dentist (License #2005002250 in MO)

🟢
Initial NPI Registration & Enumeration August 11, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

0 Reviews
No patient reviews submitted yet for Dr. Mahamid Khan. Be the first to share your experience!

Sign in to leave a review for Dr. Mahamid Khan

Only verified registered users can submit ratings, post feedback, and upload facility photos.

NPI Administrative Meta

NPI Number: 1164424016
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 11, 2005
Last Update: July 02, 2021
Sole Proprietor: No

Mailing Address

966 W 21st St

Chicago, IL 606084511

Phone: 7732541400

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.