DR. MARK I KHAIMOV DDS
NPI 1477614162
Dentist - Periodontics in Nutley, NJ

Active since December 13, 2006
180 CENTRE ST, NUTLEY, NJ 07110(973) 798-2639(973) 798-2640 Get Directions Write a Review

NPPES record last updated: July 18, 2016. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Mark I Khaimov Dds NPPES

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

DR. MARK I KHAIMOV DDS (NPI 1477614162) is an individual periodontics provider in Nutley, New Jersey, licensed in New Jersey (2249201) and active in the NPI registry since December 2006.

NPPES Registry Identity

NPI1477614162
Entity TypeIndividualMale
Primary Taxonomy1223P0300X
Provider Legal NameDR. MARK I KHAIMOVCredential: DDS
Location Address180 CENTRE STNutley, NJ 07110-2828
Mailing Address180 Centre StNutley, NJ 07110-2828 · (973) 798-2639 · Fax (973) 798-2640
Fax(973) 798-2640
Sole ProprietorYes
Enumeration DateDecember 13, 2006
Last NPPES UpdateJuly 18, 2016
NPI 1477614162 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDentist · PeriodonticsDental Providers
Taxonomy Code1223P0300X
License Licensed in NJ · 2249201
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 structures and tissues.

180 CENTRE ST, Nutley, NJ 07110

Accepted Insurance

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mark Khaimov's NPI number?

The NPI number for Mark Khaimov is 1477614162. It was assigned to this individual provider in the NPPES registry on December 13, 2006.

Where is Mark Khaimov located?

Mark Khaimov practices at 180 Centre St, Nutley, NJ 07110. The listed phone number is (973) 798-2639.

What is Mark Khaimov's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Periodontics, with taxonomy code 1223P0300X.

What insurance does Mark Khaimov accept?

Health plans from Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas, Humana and Renaissance Dental list Mark Khaimov as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Mark Khaimov was last updated on July 18, 2016. NPI Profile syncs with the weekly NPPES data releases published by CMS.