Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
OMID KHAKSARFARD
Active Sole ProprietorOMID KHAKSARFARD is a General Dentistry healthcare provider located in MT PLEASANT, Wisconsin. NPI 1780403477 is currently active in the NPPES registry. Verify at CMS.
General Dentistry · MT PLEASANT, WI
Registration Details
- NPI Number
- 1780403477
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Oct 9, 2024 (1.8609441296226 yrs)
- Last Updated
- Oct 5, 2025
- License
-
6001855 (WI)
- Sole Proprietor
- Yes
Practice Information
- Address
-
6035 DURAND AVEMT PLEASANT, WI, 534065049Browse WI providers · Browse ZIP 53406
- Phone
- 2622706933
- Primary Specialty
-
General Dentistry
1223G0001X
Other General Dentistry Providers in MT PLEASANT, WI
| Name | Credential | NPI |
|---|---|---|
| DR. MARIA BARNES | DDS | 1851822373 |
| JUN HWAN PARK | DMD | 1427822147 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.