MUJTABA KHAN
NPI 1093260366
Dentist in Green Bay, WI

Q: What is Mujtaba Khan's NPI number?

The NPI number for Mujtaba Khan is 1093260366. It was assigned to this individual provider in the NPPES registry on August 16, 2016.

Q: What is Mujtaba Khan's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Q: When was this NPI record last updated?

The NPPES record for Mujtaba Khan was last updated on January 26, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since August 16, 2016PECOS Enrolled

1931 MAIN ST, GREEN BAY, WI 54302(920) 499-2770 Get Directions Write a Review

NPPES record last updated: January 26, 2017. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jan 26, 2017, Aug 16, 2016 (2 updates tracked since 2016).

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About Mujtaba Khan NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MUJTABA KHAN (NPI 1093260366) is an individual dentist in Green Bay, Wisconsin, licensed in Wisconsin (1001454-15) and active in the NPI registry since August 2016. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1093260366

Entity TypeIndividualMale

Primary Taxonomy122300000X

Provider Legal NameMUJTABA KHAN

Location Address1931 MAIN STGreen Bay, WI 54302-3920

Mailing Address2345 Sunny Lane, Apt PGreen Bay, WI 54313 · (316) 573-9707

Phone(920) 499-2770

Sole ProprietorNo

Enumeration DateAugust 16, 2016

Last NPPES UpdateJanuary 26, 20172 updates tracked since enumeration

✔ NPI 1093260366 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers

Taxonomy Code122300000X

Licenses✔ Licensed in WI · 1001454-15✔ Licensed in IN · 12012588A

Definition

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.

1931 MAIN ST, Green Bay, WI 54302

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mujtaba Khan is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54302 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$82.92 typical visit price

range $53.90 – $163.24

Typical copayment $20.73 (range $13.47 – $40.81)

Most-billed visit code 99203

Established Patient

$67.37 typical visit price

range $17.40 – $133.76

Typical copayment $16.84 (range $4.35 – $33.44)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. MELISSA ANN YEAGER

Dental Hygienist