Sadru P Kabani, DMD MS

Primary specialty

Oral and Maxillofacial Pathology DentistryTaxonomy code 1223P0106X

License

14278 Issued in MA

Practice address

100 E Newton St G-04
Bonston Univ of Dental Med, Dept of Oral & Maxillo Path
Boston, MA 02118-2308

Phone

(617) 638-5005

Fax

(617) 638-4697

NPI assigned

Aug 30, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1255441804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E NEWTON ST G-04",
            "address_2": "BONSTON UNIV OF DENTAL MED, DEPT OF ORAL & MAXILLO PATH",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182308",
            "telephone_number": "617-638-5005",
            "fax_number": "617-638-4697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E NEWTON ST G-04",
            "address_2": "BONSTON UNIV OF DENTAL MED, DEPT OF ORAL & MAXILLO PATH",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182308",
            "telephone_number": "617-638-5005",
            "fax_number": "617-638-4697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KABANI",
        "first_name": "SADRU",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "DMD MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "MA",
            "license": "14278",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0806005",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH",
            "identifier": "8000239",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "AA1699",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FALLON COMM HEALTH",
            "identifier": "25443",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "3068028",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH PLAN",
            "identifier": "711511",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Camille Jutras, M.D.
• Marc Jonathan Jutras, MD
• Lillian Johnson Juttukonda
• Leonard Bruce Kaban, DMD MD
• Aamna Kabani
• Dima Kabbani, M.D.
• Lynda G Kabbash, MD
• Nadia Kabbej, MD
• Katherine Elizabeth Kabel, MA
• Kholoud Kabli

• Oral and Maxillofacial Pathology Dentistry in Boston, MA
• Providers in Boston, MA by specialty
• Oral and Maxillofacial Pathology Dentistry in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.