Kenny Farivari, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

7034 Issued in NE

Practice address

8041 S 83Rd Ave
La Vista, NE 68128-2490

Phone

(402) 884-1174

NPI assigned

Jun 19, 2012

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 NE

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

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 and National Provider Directory roles.

• Summit Dental Associates

  • General Practice Dentistry
  • Lavista, NE
  • NPI 1518137991
  NPD (past)
• Summit Dental Health - Brentwood LLC

  • General Practice Dentistry
  • La Vista, NE
  • NPI 1154739613
  NPD (past)

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

{
    "created_epoch": "1340064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340064000000",
    "number": "1275896847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8041 S 83RD AVE",
            "city": "LA VISTA",
            "state": "NE",
            "postal_code": "681282490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8041 S 83RD AVE",
            "city": "LA VISTA",
            "state": "NE",
            "postal_code": "681282490",
            "telephone_number": "402-884-1174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARIVARI",
        "first_name": "KENNY",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-19",
        "last_updated": "2012-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NE",
            "license": "7034",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Austin Enfield, P-C
• Farrah Erspamer, MA
• Kelsey Lauren Essink, RDN
• Zharya Mary Annette Evans
• Alyssa Falknor
• Joy Farrer
• Shelby Fastnacht
• Amber M Ferris
• Joseph Fibich, PHARM.D
• Elizabeth Anne Fichtel, PLMHP

• Dentist in La Vista, NE
• Providers in La Vista, NE by specialty
• Dentist in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2012; 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.