Individual provider Active NPI

Tania Faruqi, DDS

  • Dentist
  • Clarksville, TN
National Provider Identifier
1972064186
Registry record updated Sep 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
11400 Issued in TN
Practice address
1777 Madison St Ste 100
Clarksville, TN 37043-4912
Phone
(913) 202-9151
NPI assigned
Mar 29, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Dentist 122300000X 11400 TN Primary

Addresses

Primary practice location

1777 Madison St Ste 100
Clarksville, TN 37043-4912

Mailing address

1880 Armstrong Dr
Clarksville, TN 37042-6602
Phone (571) 426-9264

Other practice location 1

4915 25th Ave NE Ste 205
Seattle, WA 98105-5668
Phone (206) 524-1600

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
11400TNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Winston & Letwin DDS, PLLC PastSince Jul 24, 2022 Accepting new patients
Peregrine Pacific Anesthesia PLLC Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1553817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599177600000",
    "number": "1972064186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1880 ARMSTRONG DR",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370426602",
            "telephone_number": "571-426-9264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1777 MADISON ST STE 100",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370434912",
            "telephone_number": "913-202-9151"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4915 25th Ave NE Ste 205",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981055668",
            "country_code": "US",
            "telephone_number": "206-524-1600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FARUQI",
        "first_name": "TANIA",
        "name_prefix": "Miss",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-29",
        "last_updated": "2020-09-04",
        "certification_date": "2020-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TN",
            "license": "11400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarksville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2020; 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.