Provider Demographics
NPI:1831515634
Name:JABBAR, BAO KHANH (DMD, MS, MPH)
Entity type:Individual
Prefix:DR
First Name:BAO
Middle Name:KHANH
Last Name:JABBAR
Suffix:
Gender:F
Credentials:DMD, MS, MPH
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Mailing Address - Street 1:400 EL CERRO BLVD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:DANVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94526-1731
Mailing Address - Country:US
Mailing Address - Phone:925-820-8605
Mailing Address - Fax:925-831-3105
Practice Address - Street 1:5700 STONERIDGE MALL RD STE 290
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94588-2847
Practice Address - Country:US
Practice Address - Phone:254-631-4509
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-17
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CADDS1000571223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics