Active NPI
Fariba Farrokhi, DMD
- General Practice Dentistry
- South Otange, NJ
National Provider Identifier
1205942240
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DI 021574
- Practice address
- 368 S. Orange Ave
South Otange, NJ 07079 - Phone
- (973) 763-1161
- Fax
- (973) 762-0235
- NPI assigned
- Aug 22, 2006
- Last updated
- Jul 8, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DI 021574 | NJ | Primary |
Addresses
Primary practice location
368 S. Orange Ave
South Otange, NJ 07079
Mailing address
7 Rutgers St
West Orange, NJ 07052-2511
Phone (973) 736-8650
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
| License | State | Type | Specialty |
|---|---|---|---|
| DI 021574 | NJ | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156204800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1205942240",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7 RUTGERS ST",
"city": "WEST ORANGE",
"state": "NJ",
"postal_code": "070522511",
"telephone_number": "973-736-8650",
"fax_number": "973-736-8650"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "368 S. ORANGE AVE",
"city": "SOUTH OTANGE",
"state": "NJ",
"postal_code": "07079",
"telephone_number": "973-763-1161",
"fax_number": "973-762-0235"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FARROKHI",
"first_name": "FARIBA",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NJ",
"license": "DI 021574",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.