Bao Khanh Jabbar, D.M.D, M.S., M.P.H.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

DDS100057 Issued in CA

Practice address

5700 Stoneridge Mall Rd Ste 290
Pleasanton, CA 94588-2847

Phone

(254) 631-4509

NPI assigned

Mar 17, 2014

Sex

Female

Sole proprietor

Yes

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

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1395014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682467200000",
    "number": "1831515634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 EL CERRO BLVD",
            "address_2": "SUITE 106",
            "city": "DANVILLE",
            "state": "CA",
            "postal_code": "945261731",
            "telephone_number": "925-820-8605",
            "fax_number": "925-831-3105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5700 STONERIDGE MALL RD STE 290",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945882847",
            "telephone_number": "254-631-4509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JABBAR",
        "first_name": "BAO",
        "middle_name": "KHANH",
        "name_prefix": "Dr.",
        "credential": "D.M.D, M.S., M.P.H.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-03-17",
        "last_updated": "2023-04-26",
        "certification_date": "2023-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "DDS100057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ronald Edward Iverson, M.D.
• Ugochi Iwuagwu
• Kanchana Sadasivan Iyer
• Kevin Michael Izquierdo, MD
• Lindsey Rachel Izurieta, PNP
• Lexus Jackson
• Maia Jackson, BCBA
• Mary Jill Jackson, PT, DPT
• Rolonda S Jackson, RN, PHN
• Jacob Devinney DDS Inc

• Periodontics in Pleasanton, CA
• Providers in Pleasanton, CA by specialty
• Periodontics in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2023; 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.