Provider Demographics
NPI:1316672454
Name:JABLON, PAIGE (DDS)
Entity type:Individual
Prefix:DR
First Name:PAIGE
Middle Name:
Last Name:JABLON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34800 BOB WILSON DR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92134-1098
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:17457 CAFFEE RD
Practice Address - Street 2:
Practice Address - City:DAHLGREN
Practice Address - State:VA
Practice Address - Zip Code:22448-5120
Practice Address - Country:US
Practice Address - Phone:540-653-0282
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-21
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD175901223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice