Individual provider Active NPI

Reza Morvaridi Farimani

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Louisville, KY
National Provider Identifier
1417790817
Registry record updated Jun 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
11192 Issued in KY
Practice address
533 E Liberty St Unit 400
Louisville, KY 40202-1955
Phone
(929) 206-3469
NPI assigned
Jun 14, 2024
Last updated
Jun 14, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 11192 KY Primary

Addresses

Primary practice location

533 E Liberty St Unit 400
Louisville, KY 40202-1955

Mailing address

533 E Liberty St Unit 400
Louisville, KY 40202-1955
Phone (929) 206-3469

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
11192KYMDOrthodontics and Dentofacial Orthopedic Dentist

NPI Registry JSON

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

{
    "created_epoch": "1718323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718323200000",
    "number": "1417790817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "533 E LIBERTY ST UNIT 400",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021955",
            "telephone_number": "929-206-3469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "533 E LIBERTY ST UNIT 400",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021955",
            "telephone_number": "929-206-3469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORVARIDI FARIMANI",
        "first_name": "REZA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-14",
        "last_updated": "2024-06-14",
        "certification_date": "2024-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "KY",
            "license": "11192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2024; 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.