Individual provider Active NPI

Farhad Gounili, DDS

  • General Practice Dentistry
  • St Paul, MN
National Provider Identifier
1043316375
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
10513 Issued in MN
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

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061201000254 MN Practitioner - Oral Surgery 3072511922 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Group Health, Inc. General Practice CurrentSince May 31, 2011 Accepting new patients
Group Health, Inc. Current Accepting new patients
Group Health, Inc. General Practice CurrentSince May 31, 2011 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

Verify at the official NPI Registry.