EID, JABER, JASSAR, PLLC NPI 1003448820

Clinic/Center (Dental) in Federal Way, WA

Organization Clinic/Center Dental

About EID, JABER, JASSAR, PLLC

Eid, Jaber, Jassar, Pllc is a provider established in Federal Way, Washington specializing in clinic/center. The NPI number of Eid, Jaber, Jassar, Pllc is 1003448820 and was assigned on February 2020. The practitioner's primary taxonomy code is 261QD0000X. The provider is registered as an organization and their NPI record was last updated February 2020. The authorized official of this NPI record is Hazar Jaber (Ceo)

NPI

1003448820

Provider NameEID, JABER, JASSAR, PLLC
Provider Location Address32105 1ST AVE S FEDERAL WAY, WA 98003
Provider Mailing Address1717 OLYMPIA WAY LONGVIEW, WA 98632
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?Yes
Enumeration Date02-10-2020
Last Update Date02-10-2020

Primary Taxonomy

Taxonomy Code261QD0000X
ClassificationClinic/Center
TypeAmbulatory Health Care Facilities
SpecializationDental

Business Address

EID, JABER, JASSAR, PLLC
32105 1ST AVE S
FEDERAL WAY, WA
ZIP 98003
Phone: (360) 636-1900

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Mailing Address

EID, JABER, JASSAR, PLLC
1717 OLYMPIA WAY
LONGVIEW, WA
ZIP 98632
Phone: (360) 636-1900

Authorized Official

Authorized Official Name HAZAR JABER
Authorized Official TitleCEO
Authorized Official Phone(360) 636-1900

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
5045687MEDICAID (05)WA

Other Providers at the same location


The following 4 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1457430506 ALAN A MACKENZIE DDS
Individual
Dentist (General Practice)32105 1ST AVE S SUITE B-5
FEDERAL WAY, WA 98003
(253) 838-2055
1487742433DR. WAYNE ETNYRE SVOBODA DDS
Individual
Dentist32105 1ST AVE S # B3
FEDERAL WAY, WA 98003
(253) 838-2560
1619049293 JERRY CHARLES GREENFIELD DDS
Individual
Dentist (General Practice)32105 1ST AVE S B-5
FEDERAL WAY, WA 98003
(253) 838-2055
1851472096 ALEX SUTTON D.D.S.
Individual
Dentist (General Practice)32105 1ST AVE S SUITE B-1
FEDERAL WAY, WA 98003
(253) 838-4880

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.