Active NPI
Paul R Farrell, DMD
- Oral and Maxillofacial Surgery (Dentist)
- Shillington, PA
National Provider Identifier
1396844247
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)
- License
- DS-022780-L
- Practice address
- 517 E Lancaster Ave
Shillington, PA 19607-1364 - Phone
- (610) 777-7646
- Fax
- (610) 777-7570
- NPI assigned
- Sep 21, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | DS-022780-L | PA | Primary |
Addresses
Primary practice location
517 E Lancaster Ave
Shillington, PA 19607-1364
Mailing address
517 E Lancaster Ave
Shillington, PA 19607-1364
Phone (610) 777-7646
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 50004504 | Other | PA | CAPITAL BLUE CROSS |
| FA405924 | Other | PA | HIGHMARK BLUE SHIELD |
| 0009905440002 | Medicaid | PA | |
| 9922780 | Other | PA | DELTA DENTAL OF PA |
| 0009905440001 | Medicaid | PA | |
| 18605 | Other | PA | HEALTH AM/HEALTH ASSURANC |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS-022780-L | PA | MD | Oral and Maxillofacial Surgery (Dentist) |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158796800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1201564800000",
"number": "1396844247",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "517 E LANCASTER AVE",
"city": "SHILLINGTON",
"state": "PA",
"postal_code": "196071364",
"telephone_number": "610-777-7646",
"fax_number": "610-777-7570"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "517 E LANCASTER AVE",
"city": "SHILLINGTON",
"state": "PA",
"postal_code": "196071364",
"telephone_number": "610-777-7646",
"fax_number": "610-777-7570"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FARRELL",
"first_name": "PAUL",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-21",
"last_updated": "2008-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "1223S0112X",
"taxonomy_group": "",
"desc": "Dentist, Oral and Maxillofacial Surgery",
"state": "PA",
"license": "DS-022780-L",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAPITAL BLUE CROSS",
"identifier": "50004504",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HIGHMARK BLUE SHIELD",
"identifier": "FA405924",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0009905440002",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DELTA DENTAL OF PA",
"identifier": "9922780",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0009905440001",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH AM/HEALTH ASSURANC",
"identifier": "18605",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Shillington, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.