JOSE ENRIQUE IBANEZ-PABON (NPI# 1417094962) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417094962 |
| Entity Type | Individual |
| Full Name | JOSE ENRIQUE IBANEZ-PABON |
| Credential | DMD |
| Practice Address |
238 Brookley Ave Bolling Afb DC 20332-0701 |
| Mailing Address |
5483 Ashleigh Rd Fairfax VA 22030-7269 |
| Practice Telephone | 2027675382 |
| Practice Fax Number | 2027674091 |
| Mailing Telephone | 7036816464 |
| Mailing Fax Number | 7036816152 |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
21179 | OH | Dental Providers |
| Street Address |
238 BROOKLEY AVE |
| City | BOLLING AFB |
| State | DC |
| Zip Code | 20332-0701 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699776880 | James R Abbott | Family Medicine | 238 Brookley Ave, Bolling Afb, DC 20332-0001 | 2005-08-10 |
| 1467785790 | David Brian Sowers | Military Health Care Provider | 238 Brookley Ave, Bolling Afb, DC 20032 | 2009-09-18 |
| 1023245560 | Chad Michael Smith | Military Health Care Provider | 238 Brookley Ave, Bolling Afb, DC 20032 | 2009-06-11 |
| 1679626014 | David G Ray | Psychologist | 238 Brookley Ave, Bolling Afb, DC 20032-7704 | 2007-01-19 |
| 1871657874 | Cynthian Wilhelmy | Family Medicine | 238 Brookley Ave, 579 Mdg, Bolling Afb, DC 20032 | 2006-12-21 |
| 1023170263 | Alan T Smith | Dentist | 238 Brookley Ave, Bolling Afb, DC 20332 | 2006-12-14 |
| 1972516219 | Robin Christina Abbott | Physician Assistant | 238 Brookley Ave, C/o Leslie Pierson, Bolling Afb, DC 20032 | 2006-08-15 |
| 1568430528 | Susan L Black | Social Worker | 238 Brookley Ave, 11th Medical Group/sgoh, Bolling Afb, DC 20032 | 2006-03-08 |
| 1427036193 | Kurtis Lee Dean | Physician Assistant | 238 Brookley Ave, Bolling Afb, DC 20332-0001 | 2006-01-04 |
| 1114917861 | George J Gerdts | Dentist | 238 Brookley Ave, Bolling Afb, DC 20332-0001 | 2005-10-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275544405 | John Lloyd Chitwood | Physician Assistant | 238 Brookley Avenue, Bolling Afb, DC 20332 | 2006-08-11 |
| 1942438486 | John Ratnaker Mallya | Dentist | 579th Dental Squadron, Bolling Afb, Apo, AA 20332 | 2009-06-23 |
| 1710180229 | Hye Yong Choe | Student in an Organized Health Care Education/Training Program | 238 Brookley Avenue, Bolling Afb, DC 20332 | 2007-06-11 |
| 1073591285 | Diane Ruth Smith | Nurse Practitioner | 238 Brookley Ave., Bolling Afb, DC 20332-0001 | 2006-01-06 |
| 1841291937 | Mark Edward Mavity | Preventive Medicine | 11 Medical Group, 238 Brookley Avenue, Bolling Afb, DC 20332-0001 | 2005-08-10 |
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| 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. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770922478 | Heather Elise Prather | Dentist | 238 Brookley Ave Sw Bldg 1300, Bolling Afb, DC 20032-7704 | 2013-06-17 |
| 1447251574 | Grant R Hartup | Dentist | Hq Usaf/sgcd, 110 Luke Ave, Room 400, Bolling Afb, DC 20032 | 2005-08-10 |
| 1023170263 | Alan T Smith | Dentist | 238 Brookley Ave, Bolling Afb, DC 20332 | 2006-12-14 |
| 1417038936 | Tammy Knapp Heisey | Dentist | 238 Brookley Ave Sw, 579th Mdg/sghc, Bolling Afb, DC 20032-7704 | 2006-10-18 |
| 1891800587 | Paul J Nawiesniak | Dentist | 238 Brookley Ave Sw, 579 Mdg, Bolling Afb, DC 20032-7704 | 2006-08-20 |
| 1508829458 | Douglas La Roi Risk | Dentist | 110 Luke Ave Sw, Room 380, Bolling Afb, DC 20032-6400 | 2006-04-11 |
| 1114917861 | George J Gerdts | Dentist | 238 Brookley Ave, Bolling Afb, DC 20332-0001 | 2005-10-25 |
| 1972598902 | David A Stanczyk | Dentist | 238 Brookley Ave, 11 Dental Squadron/sgd, Bolling Afb, DC 20032-0701 | 2005-09-15 |
| 1336141134 | Gerard Albert Caron | Dentist | 238 Brookley Ave, 11th Dental Squadron, Bolling Afb, DC 20032-7050 | 2005-08-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508470196 | Benise Nnawuihe | Dentist | 55 M St Se, Washington, DC 20003-3522 | 2020-09-01 |
| 1124636139 | Amma Boateng | Dentist | 3651 Winfield Ln Nw, Washington, DC 20007-2385 | 2020-07-15 |
| 1760008841 | Kaitlin Elise Delaney | Dentist | 2021 K St Nw Ste 720, Washington, DC 20006-1003 | 2020-06-24 |
| 1710500871 | Robert Scott Mckernan | Dentist | 55 M St Ne Apt Ph210, Washington, DC 20002-3298 | 2020-05-24 |
| 1629691092 | City Dental Dc- 2055 L, Pllc | Dentist | 2075 L Street, Nw, Washington, DC 20036 | 2020-05-20 |
| 1275174351 | Roberts Brown & Associates | Dentist | 4300 Wheeler Rd Se, Washington, DC 20032-6036 | 2019-10-01 |
| 1841848421 | Tayler Yvette Keith Jackson | Dentist | 509 11th St Se, Washington, DC 20003-2831 | 2019-08-28 |
| 1639726243 | Matias Cima | Dentist | 4400 Jenifer St Nw Ste 340, Washington, DC 20015-2086 | 2019-08-20 |
| 1871150326 | Larosiliere and Associates Dental Care, Pa | Dentist | 2345 Martin Luther King Jr Ave Se, Washington, DC 20020-5821 | 2019-05-21 |
| 1780149773 | Dunn Dental Group Pllc | Dentist | 1712 I St Nw Ste 620, Washington, DC 20006-3751 | 2019-02-05 |
| Find all providers with the same taxonomy | ||||
| City | BOLLING AFB |
| Zip Code | 20332 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.