NPIMap

Organization Active NPI

Kwon & Jabbour Dental, Inc.

  • Dental Clinic/Center
  • Walnut Creek, CA
National Provider Identifier
1114370079
Registry record updated Jul 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
46074 Issued in CA
Legal business name
KWON & JABBOUR DENTAL, INC.
Practice address
108 La Casa Via
Suite 102
Walnut Creek, CA 94598-3013
Phone
(925) 930-8465
Fax
(925) 930-9955
NPI assigned
Jul 15, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2016

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

Authorized official

Name
Dr. Hani Jabbour, D.M.D.NPI 1639267594
Title
President
Phone
(925) 930-8465

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 46074 CA Primary
Dental Clinic/Center 261QD0000X 46279 CA

Addresses

Primary practice location

108 La Casa Via
Suite 102
Walnut Creek, CA 94598-3013

Mailing address

108 La Casa Via
Suite 102
Walnut Creek, CA 94598-3013
Phone (925) 930-8465

National Provider Directory

National Provider Directory
Tax ID family
Kwon Jabbour Dental Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

108 La Casa Via
Ste 102
Walnut Creek, CA 94598
Phone (925) 930-8465

Practitioners & affiliated clinicians

Practitioners 2

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": "1468540800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468540800000",
    "number": "1114370079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 LA CASA VIA",
            "address_2": "SUITE 102",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945983013",
            "telephone_number": "925-930-8465",
            "fax_number": "925-930-9955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 LA CASA VIA",
            "address_2": "SUITE 102",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945983013",
            "telephone_number": "925-930-8465",
            "fax_number": "925-930-9955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KWON & JABBOUR DENTAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-15",
        "last_updated": "2016-07-15",
        "status": "A",
        "authorized_official_last_name": "JABBOUR",
        "authorized_official_first_name": "HANI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "925-930-8465",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "CA",
            "license": "46074",
            "primary": true
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "CA",
            "license": "46279",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walnut Creek, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2016; 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.