Individual provider Active NPI

Omar I Faraj, DMD

  • Dentist
  • Omaha, NE
National Provider Identifier
1336620939
Registry record updated Aug 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
7508 Issued in NE
Practice address
985527 Nebraska Medical Ctr
Omaha, NE 68198-5527
Phone
(402) 559-4169
NPI assigned
Aug 22, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 7508 NE Primary

Addresses

Primary practice location

985527 Nebraska Medical Ctr
Omaha, NE 68198-5527

Mailing address

7745 Mason Ave
Burbank, IL 60459-1216
Phone (708) 717-9082

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20181107001560 NE Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 6103170360

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1534896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534896000000",
    "number": "1336620939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7745 MASON AVE",
            "city": "BURBANK",
            "state": "IL",
            "postal_code": "604591216",
            "telephone_number": "708-717-9082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "985527 NEBRASKA MEDICAL CTR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681985527",
            "telephone_number": "402-559-4169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARAJ",
        "first_name": "OMAR",
        "middle_name": "I",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-22",
        "last_updated": "2018-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NE",
            "license": "7508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.