Active NPI
Jinoos Farhang Fallah, DMD
- Dentist
- Conyers, GA
National Provider Identifier
1306824438
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN012773
- Practice address
- 1816 Lakefield CT SE
Conyers, GA 30013-6609 - Phone
- (770) 860-8760
- Fax
- (678) 413-8144
- NPI assigned
- Jan 9, 2006
- Last updated
- Jul 13, 2026
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Dentist | 122300000X | DN012773 | GA | Primary |
Addresses
Primary practice location
1816 Lakefield CT SE
Conyers, GA 30013-6609
Mailing address
1825 Parker Rd SE
# 1205
Conyers, GA 30094-2603
Phone (770) 760-7932
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 |
|---|---|---|---|
| DN012773 | GA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Smile Dental Group of Conyers 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Dental Clinic/Center
- Conyers, GA
- NPI 1235117375
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136764800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1306824438",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1825 PARKER RD SE",
"address_2": "# 1205",
"city": "CONYERS",
"state": "GA",
"postal_code": "300942603",
"telephone_number": "770-760-7932"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1816 LAKEFIELD CT SE",
"city": "CONYERS",
"state": "GA",
"postal_code": "300136609",
"telephone_number": "770-860-8760",
"fax_number": "678-413-8144"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FARHANG FALLAH",
"first_name": "JINOOS",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-09",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "GA",
"license": "DN012773",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.