Individual provider Active NPI

Christopher Daniel Farish, D.M.D.

  • General Practice Dentistry
  • Tampa, FL
National Provider Identifier
1396120002
Registry record updated Sep 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN25354 Issued in FL
Practice address
14815 N Dale Mabry Hwy
Tampa, FL 33618-2027
Phone
(813) 264-1993
NPI assigned
Jul 23, 2015
Last updated
Sep 16, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DGD.8605 GD SC
General Practice Dentistry 1223G0001X DN25354 FL Primary

Addresses

Primary practice location

14815 N Dale Mabry Hwy
Tampa, FL 33618-2027

Mailing address

14815 N Dale Mabry Hwy
Tampa, FL 33618-2027
Phone (813) 264-1993

Other practice location 1

704 Columbia Rd
Edgefield, SC 29824-4309
Phone (803) 637-6060

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20201005000837 FL Order and Referring Only - DentistPractitioner - Dentist 7315366788

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DGD.8605 GDSCMDDentist
DN25354FLMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Coast Florida P.a. Dentist CurrentSince Jun 22, 2021 Accepting new patients
Dr. Jeffery R. Gosney General Practice Past Accepting new patients
Coast Florida P.a. Dentist PastSince Sep 20, 2020 Accepting new patients
Dr. Jeffery R. Gosney General Practice Past Accepting new patients

Locations

14815 N Dale Mabry Hwy
Tampa, FL 33618
Phone (813) 264-1993

Networks

  • Freedom Health HMO Network

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1437609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600214400000",
    "number": "1396120002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14815 N DALE MABRY HWY",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336182027",
            "telephone_number": "813-264-1993",
            "fax_number": "803-637-6058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14815 N DALE MABRY HWY",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336182027",
            "telephone_number": "813-264-1993"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "704 Columbia Rd",
            "address_purpose": "LOCATION",
            "city": "Edgefield",
            "state": "SC",
            "postal_code": "298244309",
            "country_code": "US",
            "telephone_number": "803-637-6060",
            "fax_number": "803-637-6058",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FARISH",
        "first_name": "CHRISTOPHER",
        "middle_name": "DANIEL",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-07-23",
        "last_updated": "2020-09-16",
        "certification_date": "2020-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "SC",
            "license": "DGD.8605 GD",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN25354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.