Individual provider Active NPI

Austin P Farmer, DDS

  • General Practice Dentistry
  • Rockwall, TX
National Provider Identifier
1891212783
Registry record updated Nov 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
34670 Issued in TX
Practice address
1039 E Interstate 30 Ste 107
Rockwall, TX 75087-4912
Phone
(972) 722-4914
NPI assigned
Aug 23, 2017
Last updated
Nov 18, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2901022419 MI
General Practice Dentistry 1223G0001X 34670 TX Primary

Addresses

Primary practice location

1039 E Interstate 30 Ste 107
Rockwall, TX 75087-4912

Mailing address

2828 Woodside St Apt 3111
Dallas, TX 75204-3090
Phone (806) 787-8190

Other practice location 1

30301 Schoenherr Rd Ste B
Warren, MI 48088-3189
Phone (586) 573-4970

Other identifiers 1

IdentifierTypeStateIssuer
34670OtherTXTSBDE LICENSURE

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

State licenses

LicenseStateTypeSpecialty
2901022419MIMDGeneral Practice Dentistry
34670TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Rockwall Modern Dentistry and Orthodontics, PC General Practice PastSince Nov 24, 2019 Accepting new patients

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": "1503446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574035200000",
    "number": "1891212783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2828 WOODSIDE ST APT 3111",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752043090",
            "telephone_number": "806-787-8190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1039 E INTERSTATE 30 STE 107",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "750874912",
            "telephone_number": "972-722-4914"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "30301 Schoenherr Rd Ste B",
            "address_purpose": "LOCATION",
            "city": "Warren",
            "state": "MI",
            "postal_code": "480883189",
            "country_code": "US",
            "telephone_number": "586-573-4970",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FARMER",
        "first_name": "AUSTIN",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-23",
        "last_updated": "2019-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901022419",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "34670",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TSBDE LICENSURE",
            "identifier": "34670",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockwall, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 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.