Individual provider Active NPI

Samantha Farkash, DDS

  • Dentist
  • Davis, CA
National Provider Identifier
1013408319
Registry record updated Dec 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901022582 Issued in MI
Practice address
2067 Anderson Rd
Davis, CA 95616-0672
Phone
(530) 756-7400
NPI assigned
May 22, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2901022582 MI Primary

Addresses

Primary practice location

2067 Anderson Rd
Davis, CA 95616-0672

Mailing address

1431 26TH St
Sacramento, CA 95816-6314
Phone (248) 508-8538

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181218000863 MI Order and Referring Only - DentistPractitioner - Dentist 8224373394

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2901022582MIMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
James W Childress DDS Inc Dentist PastSince Dec 8, 2024 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1526947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733356800000",
    "number": "1013408319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1431 26TH ST",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958166314",
            "telephone_number": "248-508-8538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2067 ANDERSON RD",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "956160672",
            "telephone_number": "530-756-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARKASH",
        "first_name": "SAMANTHA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-22",
        "last_updated": "2024-12-05",
        "certification_date": "2024-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901022582",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davis, CA

Sources for this page

Verify at the official NPI Registry.