Individual provider Active NPI

Jean L Farbod, D.D.S.

  • General Practice Dentistry
  • Ishpeming, MI
National Provider Identifier
1205147683
Registry record updated Sep 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2901020223 Issued in MI
Practice address
125 N Pansy St
Ishpeming, MI 49849-3015
Phone
(906) 485-5575
NPI assigned
Jun 30, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2020

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 2901020223 MI Primary

Addresses

Primary practice location

125 N Pansy St
Ishpeming, MI 49849-3015

Mailing address

125 N Pansy St
Ishpeming, MI 49849-3015

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

State licenses

LicenseStateTypeSpecialty
2901020223MIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Jean L Farbod DDS PLC General Practice Current Accepting new patients
Marquette County Health Department Dental Clinic General Practice Past Accepting new patients

Locations

125 N Pansy St
Ishpeming, MI 49849
Phone (906) 485-5575

Organizations & group practices 2

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": "1277856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599523200000",
    "number": "1205147683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 N PANSY ST",
            "city": "ISHPEMING",
            "state": "MI",
            "postal_code": "498493015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 N PANSY ST",
            "city": "ISHPEMING",
            "state": "MI",
            "postal_code": "498493015",
            "telephone_number": "906-485-5575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARBOD",
        "first_name": "JEAN",
        "middle_name": "L",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-30",
        "last_updated": "2020-09-08",
        "certification_date": "2020-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901020223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ishpeming, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2020; 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.