NPIMap

Organization Active NPI

Avalon Dental LLC

  • General Practice Dentistry
  • Wilmington, DE
National Provider Identifier
1497896682
Registry record updated Jul 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
G1-10001200 Issued in DE
Legal business name
AVALON DENTAL LLC
Practice address
301 S Old Dupont Rd
Ste a
Wilmington, DE 19804-0000
Phone
(302) 998-9244
NPI assigned
Feb 9, 2007
Last updated
Jul 2, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2008

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

Authorized official

Name
Dr. Parham Farhi, DDSNPI 1639235187
Title
Owner
Phone
(302) 998-9244

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X G1-10001200 DE Primary

Addresses

Primary practice location

301 S Old Dupont Rd
Ste a
Wilmington, DE 19804-0000

Mailing address

301 S Old Dupont Rd
Ste a
Wilmington, DE 19804-0000
Phone (302) 998-9244

Other identifiers 3

IdentifierTypeStateIssuer
1000040450MedicaidDE
1000038597MedicaidDE
1000040646MedicaidDE

National Provider Directory

National Provider Directory
Tax ID family
Avalon Dental LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

301 Old DuPont Rd
Ste A
Wilmington, DE 19804
Phone (302) 503-2273

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214956800000",
    "number": "1497896682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 S OLD DUPONT RD",
            "address_2": "STE A",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198040000",
            "telephone_number": "302-998-9244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 S OLD DUPONT RD",
            "address_2": "STE A",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198040000",
            "telephone_number": "302-998-9244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVALON DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-09",
        "last_updated": "2008-07-02",
        "status": "A",
        "authorized_official_last_name": "FARHI",
        "authorized_official_first_name": "PARHAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "302-998-9244",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "DE",
            "license": "G1-10001200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000040450",
            "state": "DE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000038597",
            "state": "DE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000040646",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 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.

Verify at the official NPI Registry.