Provider Demographics
NPI:1083833032
Name:ALABAKOFF, JASON (DDS, MD)
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:
Last Name:ALABAKOFF
Suffix:
Gender:M
Credentials:DDS, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:317 N 11TH ST
Mailing Address - Street 2:
Mailing Address - City:SUNBURY
Mailing Address - State:PA
Mailing Address - Zip Code:17801-1655
Mailing Address - Country:US
Mailing Address - Phone:570-286-1631
Mailing Address - Fax:570-286-0595
Practice Address - Street 1:115 FARLEY CIR
Practice Address - Street 2:SUITE 203
Practice Address - City:LEWISBURG
Practice Address - State:PA
Practice Address - Zip Code:17837-9252
Practice Address - Country:US
Practice Address - Phone:570-524-2828
Practice Address - Fax:570-524-9199
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2008-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS031014L1223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery