Provider Demographics
NPI:1093844581
Name:JABR, SAHAR
Entity Type:Individual
Prefix:
First Name:SAHAR
Middle Name:
Last Name:JABR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1070 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:MILLBRAE
Mailing Address - State:CA
Mailing Address - Zip Code:94030-1944
Mailing Address - Country:US
Mailing Address - Phone:650-697-3273
Mailing Address - Fax:650-697-3009
Practice Address - Street 1:1070 BROADWAY
Practice Address - Street 2:
Practice Address - City:MILLBRAE
Practice Address - State:CA
Practice Address - Zip Code:94030-1944
Practice Address - Country:US
Practice Address - Phone:650-697-3273
Practice Address - Fax:650-697-3009
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA481231223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice