Individual provider Active NPI

Mona Farzaneh-Joseph, DDS

  • Dentist
  • Warr Acres, OK
National Provider Identifier
1285023911
Registry record updated Jun 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
6587 Issued in OK
Practice address
3919 N Macarthur Blvd
Warr Acres, OK 73122-2005
Phone
(405) 787-7827
NPI assigned
Jan 19, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 6587 OK Primary

Addresses

Primary practice location

3919 N Macarthur Blvd
Warr Acres, OK 73122-2005

Mailing address

5030 N May Ave Ste 424
Oklahoma City, OK 73112-6010
Phone (405) 445-0023

Other identifiers 2

IdentifierTypeStateIssuer
020580260AMedicaidOK
20-0580260-AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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

Enrollment IDStateProvider typePAC IDDetails
I20150922000901 OK Order and Referring Only - DentistPractitioner - Dentist 4082921119

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ocean Dental, PC Past Accepting new patients

Organizations & group practices 1

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": "1421625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560211200000",
    "number": "1285023911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5030 N MAY AVE STE 424",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731126010",
            "telephone_number": "405-445-0023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3919 N MACARTHUR BLVD",
            "city": "WARR ACRES",
            "state": "OK",
            "postal_code": "731222005",
            "telephone_number": "405-787-7827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARZANEH-JOSEPH",
        "first_name": "MONA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-19",
        "last_updated": "2019-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OK",
            "license": "6587",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "020580260A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20-0580260-A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warr Acres, OK

Sources for this page

Verify at the official NPI Registry.