Jake Farida, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901021256 Issued in MI

Practice address

7125 Orchard Lake Rd Ste 310
West Bloomfield, MI 48322-3620

Phone

(248) 855-1855

NPI assigned

Jul 30, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1406678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553644800000",
    "number": "1245648518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2050 PINE LAKE TRL",
            "city": "KEEGO HARBOR",
            "state": "MI",
            "postal_code": "483201307",
            "telephone_number": "248-860-1286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7125 ORCHARD LAKE RD STE 310",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483223620",
            "telephone_number": "248-855-1855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARIDA",
        "first_name": "JAKE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-30",
        "last_updated": "2019-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901021256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Faitler, LMSW
• Family Dentistry of West Bloomfield
• Jeffrey Edward Fantich, D.C.
• Madison Fantin, DDS
• Areeba Farhan
• Sandy Farida
• Theodore Paul Faris, MA, LPC
• Tiffany Lynn Farms, LMSW
• Amanda Faye Farris, MD
• Uma Farwa

• General Practice Dentistry in West Bloomfield, MI
• Providers in West Bloomfield, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.