Active NPI
Christopher Daniel Farish, D.M.D.
- General Practice Dentistry
- Tampa, FL
National Provider Identifier
1396120002
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DN25354
- Practice address
- 14815 N Dale Mabry Hwy
Tampa, FL 33618-2027 - Phone
- (813) 264-1993
- NPI assigned
- Jul 23, 2015
- Last updated
- Sep 16, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20201005000837 | FL | Order and Referring Only - Dentist | 7315366788 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DGD.8605 GD | SC | MD | Dentist |
| DN25354 | FL | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Coast Florida P.a. | Dentist | Current | Accepting new patients |
| Dr. Jeffery R. Gosney | General Practice | Past | Accepting new patients |
| Coast Florida P.a. | Dentist | Past | 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.
-
- Dentist
- Tampa, FL
- NPI 1730287673
-
- General Practice Dentistry
- Edgefield, SC
- NPI 1003003674
-
- General Practice Dentistry
- Aiken, SC
- NPI 1710174396
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2020; 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.