Haytham A Fares, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901017022 Issued in MI

Practice address

22190 Garrison St Ste 200
Dearborn, MI 48124-2235

Phone

(313) 561-7070

Fax

(313) 561-0686

NPI assigned

Mar 26, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1598883837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22190 GARRISON ST STE 200",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481242235",
            "telephone_number": "313-561-7070",
            "fax_number": "313-561-0686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22190 GARRISON ST STE 200",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481242235",
            "telephone_number": "313-561-7070",
            "fax_number": "313-561-0686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARES",
        "first_name": "HAYTHAM",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901017022",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fadi Fardous, RPH
• Mahmoud Fardous
• Fares Yasin
• Abdelkader Hassan Fares, M.D
• Fredaz Fares, NP
• Amjad M. Farha, M.D.
• Hanine Mohamad Farhat, DDS
• Heba Ali Farhat
• Lama Farhat
• Mahmoud Farhat, DDS

• General Practice Dentistry in Dearborn, MI
• Providers in Dearborn, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.