Active NPI
Kristin M Jabbs, DMD
- Endodontics
- Allentown, PA
National Provider Identifier
1114190378
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- DS036395
- Practice address
- 415 Business Park LN
Allentown, PA 18109-9120 - Phone
- (610) 820-8338
- Fax
- (610) 820-8374
- NPI assigned
- Apr 9, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endodontics | 1223E0200X | DS036395 | PA | Primary |
Addresses
Primary practice location
415 Business Park LN
Allentown, PA 18109-9120
Mailing address
415 Business Park LN
Allentown, PA 18109-9120
Phone (610) 820-8338
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DS036395 | Other | PA | DENTAL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jul 11, 2023 through Jul 11, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1207699200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1207699200000",
"number": "1114190378",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "415 BUSINESS PARK LN",
"city": "ALLENTOWN",
"state": "PA",
"postal_code": "181099120",
"telephone_number": "610-820-8338",
"fax_number": "610-820-8374"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "415 BUSINESS PARK LN",
"city": "ALLENTOWN",
"state": "PA",
"postal_code": "181099120",
"telephone_number": "610-820-8338",
"fax_number": "610-820-8374"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JABBS",
"first_name": "KRISTIN",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-04-09",
"last_updated": "2008-04-09",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "PA",
"license": "DS036395",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DENTAL",
"identifier": "DS036395",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Allentown, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.