Provider Demographics
NPI:1508359803
Name:JABIR, SAMIYA
Entity Type:Individual
Prefix:
First Name:SAMIYA
Middle Name:
Last Name:JABIR
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 1:144 N DITHRIDGE ST APT 214
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-2616
Mailing Address - Country:US
Mailing Address - Phone:724-840-6655
Mailing Address - Fax:
Practice Address - Street 1:355 5TH AVE STE 1121
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15222-2407
Practice Address - Country:US
Practice Address - Phone:412-281-6815
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-11
Last Update Date:2019-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS042046122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist