Geoffrey Kirk Faris, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D6345 Issued in OR

Practice address

2031 Hawthorne St Ste B
Forest Grove, OR 97116-1700

Phone

(503) 359-4463

Fax

(503) 359-1328

NPI assigned

Sep 5, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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 OR

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Jonathan Faris DMD PC

  • Dental Clinic/Center
  • Forest Grove, OR
  • NPI 1619743952
  NPD (past)

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

{
    "created_epoch": "1157414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1326140872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2031 HAWTHORNE ST STE B",
            "city": "FOREST GROVE",
            "state": "OR",
            "postal_code": "971161700",
            "telephone_number": "503-359-4463",
            "fax_number": "503-359-1328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2031 HAWTHORNE ST STE B",
            "city": "FOREST GROVE",
            "state": "OR",
            "postal_code": "971161700",
            "telephone_number": "503-359-4463",
            "fax_number": "503-359-1328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARIS",
        "first_name": "GEOFFREY",
        "middle_name": "KIRK",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D6345",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dina H Erickson, O.D.
• Trina Marie Espiasse, RN, M.ED
• Allison Clair Evans
• Family Haven LLC
• Family Institute, P.C.
• Jonathan Bret Faris, DMD
• Nickolas Felten, D.D.S
• Ellen J Fiscus, MA, LPC, NCC
• Rebecca Flagg, RPH
• Janeen VI Flake, RPH

• General Practice Dentistry in Forest Grove, OR
• Providers in Forest Grove, OR by specialty
• General Practice Dentistry in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.