Individual provider Active NPI

John Farah, D.D.S.

  • General Practice Dentistry
  • Ann Arbor, MI
National Provider Identifier
1629194014
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
11802 Issued in MI
Practice address
3100 W Liberty Rd Ste a
Ann Arbor, MI 48103-8724
Phone
(734) 663-6777
Fax
(734) 663-9820
NPI assigned
Mar 21, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 11802 MI Primary

Addresses

Primary practice location

3100 W Liberty Rd Ste a
Ann Arbor, MI 48103-8724

Mailing address

3100 W Liberty Rd Ste a
Ann Arbor, MI 48103-8724
Phone (734) 663-6777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20161020000201 FL Order and Referring Only - DentistPractitioner - Dentist 5799003810

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11802MIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Enspire Dental PLLC Past Accepting new patients

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Catholic Home Health Services of Miami Dade CountyMiami Lakes, FL, CCN 107670 Home health agency Corporate Officer Jan 1, 2002

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629194014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 W LIBERTY RD STE A",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481038724",
            "telephone_number": "734-663-6777",
            "fax_number": "734-663-9820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 W LIBERTY RD STE A",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481038724",
            "telephone_number": "734-663-6777",
            "fax_number": "734-663-9820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARAH",
        "first_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "11802",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.