Individual provider Active NPI

Farhad Foroutan

  • Dentist
  • Anaheim, CA
National Provider Identifier
1942471768
Registry record updated Mar 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
46794 Issued in CA
Practice address
5031 E Orangethorpe Ave
Suite B-2
Anaheim, CA 92807-1131
Phone
(714) 693-1889
Fax
(714) 693-1798
NPI assigned
Mar 19, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 46794 CA Primary

Addresses

Primary practice location

5031 E Orangethorpe Ave
Suite B-2
Anaheim, CA 92807-1131

Mailing address

5031 E Orangethorpe Ave
Suite B-2
Anaheim, CA 92807-1131
Phone (714) 693-1889

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20160815002972 CA Order and Referring Only - DentistPractitioner - Dentist 5092009928

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
46794CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1205884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205884800000",
    "number": "1942471768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5031 E ORANGETHORPE AVE",
            "address_2": "SUITE B-2",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928071131",
            "telephone_number": "714-693-1889",
            "fax_number": "714-693-1798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5031 E ORANGETHORPE AVE",
            "address_2": "SUITE B-2",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928071131",
            "telephone_number": "714-693-1889",
            "fax_number": "714-693-1798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOROUTAN",
        "first_name": "FARHAD",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-19",
        "last_updated": "2008-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "46794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

Verify at the official NPI Registry.