Jason Saad-Eddine Daaboul, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

20482 Issued in TX

Practice address

2800 William D Tate Ave
Suite 200
Grapevine, TX 76051-4327

Phone

(817) 424-3214

Fax

(817) 421-6176

NPI assigned

Jan 11, 2007

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Jason S. Daaboul DDS PA

  • Dental Clinic/Center
  • Grapevine, TX
  • NPI 1407555121
  NPD Authorized official

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629128715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 WILLIAM D TATE AVE",
            "address_2": "SUITE 200",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760514327",
            "telephone_number": "817-424-3214",
            "fax_number": "817-421-6176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 WILLIAM D TATE AVE",
            "address_2": "SUITE 200",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760514327",
            "telephone_number": "817-424-3214",
            "fax_number": "817-421-6176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAABOUL",
        "first_name": "JASON",
        "middle_name": "SAAD-EDDINE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "20482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Grapevine, TX
• Providers in Grapevine, TX by specialty
• General Practice Dentistry in Texas

• 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.