Individual provider Active NPI

Sahar Hajibabaei

  • Dentist
  • Jacksonville, FL
National Provider Identifier
1427809169
Registry record updated Jul 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
30697 Issued in FL
Practice address
14006 Beach Blvd
Jacksonville, FL 32250-1597
Phone
(904) 921-2362
NPI assigned
Mar 29, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 30697 FL Primary

Addresses

Primary practice location

14006 Beach Blvd
Jacksonville, FL 32250-1597

Mailing address

467 Rum Runner Way
St Johns, FL 32259-2279
Phone (703) 862-0529

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
30697FLMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1711670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752105600000",
    "number": "1427809169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "467 RUM RUNNER WAY",
            "city": "ST JOHNS",
            "state": "FL",
            "postal_code": "322592279",
            "telephone_number": "703-862-0529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14006 BEACH BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322501597",
            "telephone_number": "904-921-2362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAJIBABAEI",
        "first_name": "SAHAR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-29",
        "last_updated": "2025-07-10",
        "certification_date": "2025-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "30697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2025; 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.