Individual provider Active NPI

Sana Abdel-Jabbar, D.M.D

  • Dentist
  • Boca Raton, FL
National Provider Identifier
1801248372
Registry record updated Jul 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN 21987 Issued in FL
Practice address
350 Club Cir Apt 202
Boca Raton, FL 33487-3743
Phone
(954) 612-5338
NPI assigned
Jul 8, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN 21987 FL Primary

Addresses

Primary practice location

350 Club Cir Apt 202
Boca Raton, FL 33487-3743

Mailing address

350 Club Cir Apt 202
Boca Raton, FL 33487-3743
Phone (954) 612-5338

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20161214001719 FL Order and Referring Only - DentistPractitioner - Dentist 5991085615

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN 21987FLMDDentist

Networks

  • Freedom Health HMO Network

NPI Registry JSON

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

{
    "created_epoch": "1467936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467936000000",
    "number": "1801248372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 CLUB CIR APT 202",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334873743",
            "telephone_number": "954-612-5338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 CLUB CIR APT 202",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334873743",
            "telephone_number": "954-612-5338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABDEL-JABBAR",
        "first_name": "SANA",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-08",
        "last_updated": "2016-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN 21987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

Verify at the official NPI Registry.