Farhan Abbas Momin, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN015960 Issued in GA

Practice address

8709 Dallas Acworth Hwy
Dallas, GA 30132-2177

Phone

(770) 693-4400

NPI assigned

Sep 26, 2019

Last updated

Sep 26, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Croxton Dental LLC

  • General Practice Dentistry
  • Dallas, GA
  • NPI 1669237590
  NPD

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

{
    "created_epoch": "1569456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569456000000",
    "number": "1700437118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 NORTON AVE",
            "city": "ACWORTH",
            "state": "GA",
            "postal_code": "301012719",
            "telephone_number": "404-952-3956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8709 DALLAS ACWORTH HWY",
            "city": "DALLAS",
            "state": "GA",
            "postal_code": "301322177",
            "telephone_number": "770-693-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOMIN",
        "first_name": "FARHAN ABBAS",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-26",
        "last_updated": "2019-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN015960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kamarie Dylanna-Makela Mitchell
• Tiffany Shulonda Mitchell, CADCII, ICADC
• Briana Mizrahi
• Shem Mobisa
• Momentum Behavioral Services
• Mohammad Mehdi Momtahan, PH.D.
• Annette Moncion, NP
• Gabriela Monge, MS, NBC-HWC, CWP
• Katie Montgomery, MED
• Laura O Moore, BSN, MN, RN

• General Practice Dentistry in Dallas, GA
• Providers in Dallas, GA by specialty
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2019; 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.