Samira Farokh, D.M.D

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

S6-168 Issued in NV

Practice address

3896 N MLK Blvd
North Las Vegas, NV 89032-6603

Phone

(702) 395-5437

Fax

(702) 933-0190

NPI assigned

Dec 21, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1356048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560729600000",
    "number": "1497091367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2109 BACHELOR CT",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891287620",
            "telephone_number": "702-234-8557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3896 N MLK BLVD",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890326603",
            "telephone_number": "702-395-5437",
            "fax_number": "702-933-0190"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2109 Bachelor Ct",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891287620",
            "country_code": "US",
            "telephone_number": "702-234-8557",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAROKH",
        "first_name": "SAMIRA",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-12-21",
        "last_updated": "2019-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NV",
            "license": "6328",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NV",
            "license": "S6-168",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVERS LICENSE",
            "identifier": "0001719087",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Morteza Farasat, M.D.
• Christopher Farley
• Farmacia del Pueblo Inc
• Jarre Farmer
• Shaneika Farmer
• Michelle Irene Farrell
• Idrish Farris
• Clyde H Farrow
• Alex Faucheux
• Alexis T Faumuina

• Pediatric Dentistry in North Las Vegas, NV
• Providers in North Las Vegas, NV by specialty
• Pediatric Dentistry in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2019; 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.

Verify at the official NPI Registry.