Provider Demographics
NPI:1861957672
Name:JABBOUR, ZAHER (DMD)
Entity type:Individual
Prefix:DR
First Name:ZAHER
Middle Name:
Last Name:JABBOUR
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:494 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:VT
Mailing Address - Zip Code:05855-4919
Mailing Address - Country:US
Mailing Address - Phone:802-334-1400
Mailing Address - Fax:
Practice Address - Street 1:100 MEDICAL PLAZA SUITE 350
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90095-4919
Practice Address - Country:US
Practice Address - Phone:310-794-5750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-06
Last Update Date:2022-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT016.0133877122300000X
CADDS104762122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist