Organization Active NPI

Farid Farahnik DDS Inc., a Professional Corporation

  • Dentist
  • Marina del Rey, CA
National Provider Identifier
1134850084
Registry record updated Jun 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
FARID FARAHNIK DDS INC., A PROFESSIONAL CORPORATION
Practice address
3017 Washington Blvd
Marina del Rey, CA 90292-5548
Phone
(310) 500-0720
NPI assigned
Jun 21, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2022

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

Authorized official

Name
Dr. Farid Farahnik, DDSNPI 1477032761
Title
President
Phone
(310) 500-0720

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

3017 Washington Blvd
Marina del Rey, CA 90292-5548

Mailing address

3017 Washington Blvd
Marina del Rey, CA 90292-5548
Phone (310) 500-0720

Other names 1

  • MARINA ADVANCED DENTISTRY Doing business as

National Provider Directory

National Provider Directory

Locations

3017 Washington Blvd
Marina del Rey, CA 90292
Phone (310) 500-0720

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1655769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655769600000",
    "number": "1134850084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3017 WASHINGTON BLVD",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902925548",
            "telephone_number": "310-500-0720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3017 WASHINGTON BLVD",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902925548",
            "telephone_number": "310-500-0720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FARID FARAHNIK DDS INC., A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-21",
        "last_updated": "2022-06-21",
        "certification_date": "2022-06-21",
        "status": "A",
        "authorized_official_last_name": "FARAHNIK",
        "authorized_official_first_name": "FARID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-500-0720",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MARINA ADVANCED DENTISTRY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Marina del Rey, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.