NPIMap

Organization Active NPI

Eid, Jaber, Jassar, PLLC

  • Dental Clinic/Center
  • Chehalis, WA
National Provider Identifier
1013549831
Registry record updated Feb 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
EID, JABER, JASSAR, PLLC
Practice address
1461 NW Louisiana Ave
Chehalis, WA 98532-1749
Phone
(360) 636-1900
NPI assigned
Feb 10, 2020
Organization subpart
Yes
Parent organization
EID, JABER, JASSAR, PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 10, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Hazar Jaber
Title
Ceo
Phone
(360) 636-1900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

1461 NW Louisiana Ave
Chehalis, WA 98532-1749

Mailing address

1717 Olympia Way
Longview, WA 98632-3929
Phone (360) 636-1900

Other identifiers 1

IdentifierTypeStateIssuer
5045687MedicaidWA

Other names 1

  • Happy Kids Dentistry Chehalis Other name

National Provider Directory

National Provider Directory
Tax ID family
Eid Jaber Jassar PLLC7 organizations share this tax ID, including this one
Part of
Eid Jaber Jassar PLLC

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1461 NW Louisiana Ave
Chehalis, WA 98532

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1581292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581292800000",
    "number": "1013549831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 OLYMPIA WAY",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986323929",
            "telephone_number": "360-636-1900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1461 NW LOUISIANA AVE",
            "city": "CHEHALIS",
            "state": "WA",
            "postal_code": "985321749",
            "telephone_number": "360-636-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EID, JABER, JASSAR, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EID, JABER, JASSAR, PLLC",
        "enumeration_date": "2020-02-10",
        "last_updated": "2020-02-10",
        "certification_date": "2020-02-10",
        "status": "A",
        "authorized_official_last_name": "JABER",
        "authorized_official_first_name": "HAZAR",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "360-636-1900"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5045687",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Happy Kids Dentistry Chehalis",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Chehalis, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.