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Individual
DR. ETHAN S KHAZALI
Active
Individual
DR. ETHAN S KHAZALI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DDS111702
CA
122300000X
Dentist
Primary
DN124057
GA
1223G0001X
General Practice Dentistry
11443
TN
1223G0001X
General Practice Dentistry
DE60862683
WA
Other
Enumeration date
08/23/2018
Last updated
01/23/2026
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