DR. NIZAM JABBOUR DDS NPI 1316066046

NPI Information

NPI: 1316066046
Provider Name: DR. NIZAM JABBOUR, DDS
Classification: Dentist - 1223G0001X
Specialization: General Practice
Entity Type: Individual
PECOS Registration: Yes
Address: 153 ACADEMY ST
POUGHKEEPSIE, NY
ZIP 12601
Phone: (845) 454-0560

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NPI Details

DR. Nizam Jabbour, DDS is a general practice dentist in Poughkeepsie, NY. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. DR. Nizam Jabbour, DDS NPI is 1316066046. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

153 ACADEMY ST
POUGHKEEPSIE, NY
ZIP 12601-521
Phone: (845) 454-0560
Fax: (845) 454-0563

The NPI 1316066046 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 3/27/2007 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	1223G0001X	Dentist	General Practice	047351-1	NEW YORK	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	02156036	MEDICAID	NEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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