Mina Farag, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

22DI02779900 Issued in NJ

Practice address

901 Dehirsch Ave
Woodbine, NJ 08270-2341

Phone

(609) 861-2784

NPI assigned

Oct 25, 2019

Last updated

Oct 25, 2019By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Woodbine Dental PA

  • Dentist
  • Woodbine, NJ
  • NPI 1700919594
  NPD (past)

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

{
    "created_epoch": "1571961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571961600000",
    "number": "1245873934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 DEHIRSCH AVE",
            "city": "WOODBINE",
            "state": "NJ",
            "postal_code": "082702341",
            "telephone_number": "609-861-2784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 DEHIRSCH AVE",
            "city": "WOODBINE",
            "state": "NJ",
            "postal_code": "082702341",
            "telephone_number": "609-861-2784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARAG",
        "first_name": "MINA",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-25",
        "last_updated": "2019-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI02779900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chris Thomas Devaney Jr.
• Megan Dickinson, RN
• Valerie Lynn Duff, CNA
• Cheryle Eisele
• Howard Epstein, DMD
• Chelsea M Farrow, APN
• Lauren Joan Gant
• Julia Lynn Hankerson, LCSW
• Nancy Marie Hansen
• Bernette Harrison, LMT

• Dentist in Woodbine, NJ
• Providers in Woodbine, NJ by specialty
• Dentist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2019; 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.