Individual provider Active NPI

Ramy Farag

  • General Practice Dentistry
  • Huntington Beach, CA
National Provider Identifier
1043904519
Registry record updated Jul 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DDS111538 Issued in CA
Practice address
6200 Edinger Ave Apt 709
Huntington Beach, CA 92647-8104
Phone
(657) 502-7996
NPI assigned
Jun 6, 2023
Last updated
Jul 16, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2025

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 DDS111538 CA Primary

Addresses

Primary practice location

6200 Edinger Ave Apt 709
Huntington Beach, CA 92647-8104

Mailing address

4410 Leonard Way
Corona, CA 92883-0672
Phone (657) 502-7996

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20250916003517 CA Order and Referring Only - DentistPractitioner - Dentist 7214431980

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DDS111538CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1686009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752624000000",
    "number": "1043904519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4410 LEONARD WAY",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928830672",
            "telephone_number": "657-502-7996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6200 EDINGER AVE APT 709",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926478104",
            "telephone_number": "657-502-7996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARAG",
        "first_name": "RAMY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-06-06",
        "last_updated": "2025-07-16",
        "certification_date": "2025-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "DDS111538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington Beach, CA

Sources for this page

Verify at the official NPI Registry.