Kajuana Pearldealia Farrey, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN013880 Issued in GA

Practice address

513 S Main St
Moultrie, GA 31768-4637

Phone

(229) 890-3908

Fax

(229) 890-3909

NPI assigned

May 30, 2009

Last updated

Mar 27, 2011By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

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

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.

• Farrey Family Dentistry LLC

  • General Practice Dentistry
  • Moultrie, GA
  • NPI 1265731442
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1243641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301184000000",
    "number": "1790911170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2229",
            "city": "MOULTRIE",
            "state": "GA",
            "postal_code": "317762229",
            "telephone_number": "229-890-3908",
            "fax_number": "229-890-3909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "513 S MAIN ST",
            "city": "MOULTRIE",
            "state": "GA",
            "postal_code": "317684637",
            "telephone_number": "229-890-3908",
            "fax_number": "229-890-3909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARREY",
        "first_name": "KAJUANA",
        "middle_name": "PEARLDEALIA",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-05-30",
        "last_updated": "2011-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "GA",
            "license": "DN013880",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN013880",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "148974731B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anna Marie Faircloth, OTR/L
• Jonathan Fairley, MD
• Family Recovery of Southwest Georgia
• Valarie Gay Farmer
• Farrey Family Dentistry LLC
• Abby Patterson Felts, FNP-C
• Jessica Fields, NP-C
• First Choice Women's Care PC
• Katelyn Fletcher, SLP
• Shelby McCoy Flowers, DO

• General Practice Dentistry in Moultrie, GA
• Providers in Moultrie, 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 Mar 27, 2011; 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.