Active NPI
Matthew Clifton Farzin, D.D.S.
- Dentist
- Cockeysville, MD
National Provider Identifier
1689040008
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 16047
- Practice address
- 5 Shawan Rd
2ND Floor
Cockeysville, MD 21030-1373 - Phone
- (443) 275-9641
- NPI assigned
- Aug 19, 2015
- Last updated
- Aug 19, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 16047 | MD | Primary |
Addresses
Primary practice location
5 Shawan Rd
2ND Floor
Cockeysville, MD 21030-1373
Mailing address
5 Shawan Rd
2ND Floor
Cockeysville, MD 21030-1373
Phone (443) 275-9641
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1439942400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1439942400000",
"number": "1689040008",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5 SHAWAN RD",
"address_2": "2ND FLOOR",
"city": "COCKEYSVILLE",
"state": "MD",
"postal_code": "210301373",
"telephone_number": "443-275-9641"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5 SHAWAN RD",
"address_2": "2ND FLOOR",
"city": "COCKEYSVILLE",
"state": "MD",
"postal_code": "210301373",
"telephone_number": "443-275-9641"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FARZIN",
"first_name": "MATTHEW",
"middle_name": "CLIFTON",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-08-19",
"last_updated": "2015-08-19",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MD",
"license": "16047",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.