Active NPI
Farid Moghaddam, D.M.D.
- Dentist
- Cumming, GA
National Provider Identifier
1184635484
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128a(1) exclusion effective Jun 18, 2026.
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN013337
- Practice address
- 1715 Friendship Cir Ste 100
Cumming, GA 30028-6918 - Phone
- (678) 860-9911
- NPI assigned
- Aug 11, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Dentist | 122300000X | DN013337 | GA | Primary |
Addresses
Primary practice location
1715 Friendship Cir Ste 100
Cumming, GA 30028-6918
Mailing address
1715 Friendship Cir Ste 100
Cumming, GA 30028-6918
Phone (678) 860-9911
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN013337 | GA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155254400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1314057600000",
"number": "1184635484",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1715 FRIENDSHIP CIR STE 100",
"city": "CUMMING",
"state": "GA",
"postal_code": "300286918",
"telephone_number": "678-860-9911"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1715 FRIENDSHIP CIR STE 100",
"city": "CUMMING",
"state": "GA",
"postal_code": "300286918",
"telephone_number": "678-860-9911"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOGHADDAM",
"first_name": "FARID",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-11",
"last_updated": "2011-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "GA",
"license": "DN013337",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cumming, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.