Active NPI
Elizabeth Arnett Jabbour DMD
- Dental Clinic/Center
- Spartanburg, SC
National Provider Identifier
1235501024
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Clinic/Center
- License
- 3148
- Legal business name
- ELIZABETH ARNETT JABBOUR DMD
- Practice address
- 402 S Pine St
Spartanburg, SC 29302-2712 - Phone
- (864) 582-2371
- Fax
- (864) 585-1949
- NPI assigned
- Oct 20, 2015
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mary Elizabeth Arnett Jabbour, DMD
- Title
- Owner/Dentist
- Phone
- (864) 582-2371
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Clinic/Center | 261QD0000X | 3148 | SC | Primary |
| Durable Medical Equipment & Medical Supplies | 332B00000X |
Addresses
Primary practice location
402 S Pine St
Spartanburg, SC 29302-2712
Mailing address
402 S Pine St
Spartanburg, SC 29302-2712
Phone (864) 582-2371
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407987399 | Medicaid | SC |
National Provider Directory
National Provider DirectoryLocations
402 S Pine St
Spartanburg, SC 29302
Phone (864) 582-2371
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1445299200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1635292800000",
"number": "1235501024",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "402 S PINE ST",
"city": "SPARTANBURG",
"state": "SC",
"postal_code": "293022712",
"telephone_number": "864-582-2371",
"fax_number": "864-585-1949"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "402 S PINE ST",
"city": "SPARTANBURG",
"state": "SC",
"postal_code": "293022712",
"telephone_number": "864-582-2371",
"fax_number": "864-585-1949"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ELIZABETH ARNETT JABBOUR DMD",
"organizational_subpart": "NO",
"enumeration_date": "2015-10-20",
"last_updated": "2021-10-27",
"certification_date": "2021-10-27",
"status": "A",
"authorized_official_last_name": "ARNETT JABBOUR",
"authorized_official_first_name": "MARY",
"authorized_official_middle_name": "ELIZABETH",
"authorized_official_title_or_position": "OWNER/DENTIST",
"authorized_official_telephone_number": "864-582-2371",
"authorized_official_credential": "DMD"
},
"taxonomies": [
{
"code": "261QD0000X",
"taxonomy_group": "",
"desc": "Clinic/Center, Dental",
"state": "SC",
"license": "3148",
"primary": true
},
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1407987399",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Spartanburg, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.