Joby E. Jaberi, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

S49 Issued in MN

Practice address

1000 E 1St St
Suite 302
Duluth, MN 55805-2297

Phone

(218) 722-1854

Fax

(218) 722-6424

NPI assigned

Jun 9, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Oral Surgery

Education

University of Minnesota School of Dentistry, 2006

Medicare assignment

May accept Medicare assignment

Group practices

Dakota Valley Oral and Maxillofacial Surgery PLLCGroup PAC ID 9436127560, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Dakota Valley Oral and Maxillofacial Surgery, PLLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Saint Paul, MN
  • NPI 1366568206
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1181347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344211200000",
    "number": "1407059009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 E 1ST ST",
            "address_2": "SUITE 302",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558052297",
            "telephone_number": "218-722-1854",
            "fax_number": "218-722-6424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 E 1ST ST",
            "address_2": "SUITE 302",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558052297",
            "telephone_number": "218-722-1854",
            "fax_number": "218-722-6424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JABERI",
        "first_name": "JOBY",
        "middle_name": "E.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-09",
        "last_updated": "2012-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TX",
            "license": "0022997",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MN",
            "license": "S49",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WI",
            "license": "6859-15",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Jean Isernhagen, PT
• Linda Israel
• Alia Mohamed Yusuf Issa
• Christine Iverson, LMT
• Okechukwu Nneji Iwu
• Maria Anne Jacenko, PT
• Brienna Grace Jackman
• Mary Ann Jacks
• Claudine Jacqueline Jackson, O.D.
• Sarah M Jackson, PT

• Oral and Maxillofacial Surgery (Dentist) in Duluth, MN
• Providers in Duluth, MN by specialty
• Oral and Maxillofacial Surgery (Dentist) in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.