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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

KHANSA KHUSRO DDS
NPI 1780420059
Dentist - General Practice in Marietta, GA

Active since July 05, 2024PECOS Enrolled
4250 ROSWELL RD STE 110, MARIETTA, GA 30062(770) 509-5585 Get Directions Write a Review

NPPES record last updated: November 4, 2026. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Nov 4, 2026, Feb 11, 2025, Jul 5, 2024 (3 updates tracked since 2024).

About Khansa Khusro Dds NPPES

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

KHANSA KHUSRO DDS (NPI 1780420059) is an individual general practice provider in Marietta, Georgia, licensed in Georgia (DN124431) and active in the NPI registry since July 2024. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1780420059
Entity TypeIndividualFemale
Primary Taxonomy1223G0001X
Provider Legal NameKHANSA KHUSROCredential: DDS
Location Address4250 ROSWELL RD STE 110Marietta, GA 30062-8114
Mailing Address4250 Roswell Rd Ste 110Marietta, GA 30062-8114 · (805) 667-7751
Phone(770) 509-5585
Sole ProprietorNo
Enumeration DateJuly 5, 2024
Last NPPES UpdateNovember 4, 20263 updates tracked since enumeration
NPPES CertifiedNovember 4, 2026
✔ NPI 1780420059 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
Licenses✔ Licensed in GA · DN124431✔ Licensed in MI · 2901602297✔ Licensed in CA · DDS111020
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
4250 ROSWELL RD STE 110, Marietta, GA 30062
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Montana 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)

Khansa Khusro Dds 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 30062 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
$88.06 typical visit price
range $56.84 – $172.43
Typical copayment $22.01 (range $14.21 – $43.10)
Most-billed visit code 99203
Established Patient
$70.85 typical visit price
range $18.22 – $140.40
Typical copayment $17.71 (range $4.55 – $35.10)
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 6

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

DAVID CHYAN DMD
Dentist (General Practice)
4250 ROSWELL RD STE 110
MARIETTA, GA 30062
Cobb County (770) 509-5585
DR. JENNIFER OROZCO DMD
Dentist (Endodontics)
4250 ROSWELL RD STE 110
MARIETTA, GA 30062
Cobb County (770) 509-5585
STEPHANIE KIM
Dentist (General Practice)
4250 ROSWELL RD STE 110
MARIETTA, GA 30062
Cobb County (770) 509-5585
JOHNSON FERRY DENTISTRY, PC
Dentist
4250 ROSWELL RD STE 110
MARIETTA, GA 30062
Cobb County (770) 509-5585
DR. KATIE HABER
Dentist (Endodontics)
4250 ROSWELL RD STE 110
MARIETTA, GA 30062
Cobb County (770) 509-5585
DR. SARAH ABDULHAMEED DMD
Dentist (General Practice)
4250 ROSWELL RD STE 110
MARIETTA, GA 30062
Cobb County (770) 509-5585

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 Khansa Khusro's NPI number?

The NPI number for Khansa Khusro is 1780420059. It was assigned to this individual provider in the NPPES registry on July 5, 2024.

Where is Khansa Khusro located?

Khansa Khusro practices at 4250 Roswell Rd Ste 110, Marietta, GA 30062. The listed phone number is (770) 509-5585.

What is Khansa Khusro's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Is Khansa Khusro enrolled in Medicare?

Yes. Khansa Khusro is registered in the Medicare PECOS enrollment system.

What insurance does Khansa Khusro accept?

Health plans from Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross Blue Shield of Michigan Mutual Insurance Company, Blue Cross and Blue Shield of Montana and Blue Cross and Blue Shield of Oklahoma and 15 other insurers list Khansa Khusro 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 Khansa Khusro was last updated on November 4, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 days 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.