Sanaz Jabbari, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D14538 Issued in MN

Practice address

2165 White Bear Ave N
Maplewood, MN 55109-2707

Phone

(651) 523-9900

NPI assigned

Jun 24, 2021

Sex

Female

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

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

Medicare enrollment (NPD)

Enrolled

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.

• Group Health, Inc.

  • Multi-Specialty Clinic/Center
  • Minneapolis, MN
  • NPI 1710924683
  Medicare reassignment NPD
• Group Health, Inc.

  • General Practice Dentistry
  • White Bear Lake, MN
  • NPI 1275688632
  NPD
• Group Health, Inc.

  • General Practice Dentistry
  • Saint Paul, MN
  • NPI 1952042053
  NPD
• West Side Community Health Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Saint Paul, MN
  • NPI 1043187289
  NPD (past)
• West Side Community Health Services, Inc.

  • Dental Clinic/Center
  • Saint Paul, MN
  • NPI 1417007436
  NPD (past)

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

{
    "created_epoch": "1624492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694476800000",
    "number": "1699344499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2074 PRINCETON AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551051117",
            "telephone_number": "952-594-4663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2165 WHITE BEAR AVE N",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551092707",
            "telephone_number": "651-523-9900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JABBARI",
        "first_name": "SANAZ",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-24",
        "last_updated": "2023-09-12",
        "certification_date": "2023-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D14538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Interactive Therapy Services, Inc.
• Nadeem Iqbal, M.D.
• Isd 622 Gladstone Meals on Wheels
• Alexander Ivaskovic, MD
• Kathleen Ann Iverson, LDH
• Danielle Margaret Colette Jackson, MD
• Katrina Margaret Jackson, CNP
• Thomas R. Jacques, M.D.
• Raeann Jaeb, OTR/L
• Laura Lea Jaeger, DPT

• General Practice Dentistry in Maplewood, MN
• Providers in Maplewood, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.