Individual provider Active NPI

Scott Carl Farrell, DDS

  • General Practice Dentistry
  • Snellville, GA
National Provider Identifier
1326250762
Registry record updated Feb 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN015126 Issued in GA
Practice address
2220 Wisteria Dr Ste 300
Snellville, GA 30078-4604
Phone
(678) 836-2107
NPI assigned
May 6, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 3904 AR
General Practice Dentistry 1223G0001X 2901017310 MI
General Practice Dentistry 1223G0001X 25210 TX
General Practice Dentistry 1223G0001X DN015126 GA Primary

Addresses

Primary practice location

2220 Wisteria Dr Ste 300
Snellville, GA 30078-4604

Mailing address

2220 Wisteria Dr Ste 300
Snellville, GA 30078-4604
Phone (678) 836-2107

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

LicenseStateTypeSpecialty
3904ARMDGeneral Practice Dentistry
DN015126GAMDGeneral Practice Dentistry
2901017310MIMDGeneral Practice Dentistry
25210TXMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1178409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644192000000",
    "number": "1326250762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2220 WISTERIA DR STE 300",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300784604",
            "telephone_number": "678-836-2107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2220 WISTERIA DR STE 300",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300784604",
            "telephone_number": "678-836-2107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARRELL",
        "first_name": "SCOTT",
        "middle_name": "CARL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-06",
        "last_updated": "2022-02-07",
        "certification_date": "2022-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "3904",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901017310",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "25210",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN015126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Snellville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2022; 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.