Provider Demographics
NPI:1346528825
Name:DABELL PAVENTY PLLC
Entity Type:Organization
Organization Name:DABELL PAVENTY PLLC
Other - Org Name:DABELL ORTHODONTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ORTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JACOB
Authorized Official - Middle Name:E
Authorized Official - Last Name:DABELL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MSD
Authorized Official - Phone:509-921-1700
Mailing Address - Street 1:720 N EVERGREEN RD
Mailing Address - Street 2:STE 101
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99216-0856
Mailing Address - Country:US
Mailing Address - Phone:509-921-1700
Mailing Address - Fax:509-921-5804
Practice Address - Street 1:720 N EVERGREEN RD
Practice Address - Street 2:STE 101
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99216-0856
Practice Address - Country:US
Practice Address - Phone:509-921-1700
Practice Address - Fax:509-921-5804
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-01
Last Update Date:2019-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE 600130391223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty