Active NPI
Farhad Gounili, DDS
- General Practice Dentistry
- St Paul, MN
National Provider Identifier
1043316375
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 10513
- Practice address
- 2500 Como Ave
St Paul, MN 55108 - Phone
- (651) 641-0020
- Fax
- (651) 632-8984
- NPI assigned
- Sep 15, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 10513 | MN | Primary |
Addresses
Primary practice location
2500 Como Ave
St Paul, MN 55108
Mailing address
PO Box 1309
Mail Code 21113a
Minneapolis, MN 55440-1309
Phone (952) 883-5151
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20061201000254 | MN | Practitioner - Oral Surgery | 3072511922 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Group Health, Inc. | General Practice | Current | Accepting new patients |
| Group Health, Inc. | Current | Accepting new patients | |
| Group Health, Inc. | General Practice | Current | Accepting new patients |
Locations
8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600
3930 Northwoods Dr
Saint Paul, MN 55112
Phone (651) 490-6775
2500 Como Ave
Saint Paul, MN 55108
Phone (651) 641-6200
8325 Seasons Pkwy
Ste 103
Woodbury, MN 55125
Phone (651) 702-5848
Organizations & group practices 3
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": "1158278400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1043316375",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1309",
"address_2": "MAIL CODE 21113A",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554401309",
"telephone_number": "952-883-5151",
"fax_number": "952-883-5160"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2500 COMO AVE",
"city": "ST PAUL",
"state": "MN",
"postal_code": "55108",
"telephone_number": "651-641-0020",
"fax_number": "651-632-8984"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOUNILI",
"first_name": "FARHAD",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MN",
"license": "10513",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in St Paul, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.