MEDICARE: JOSEPH MARTIN FARKASH D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	2901022328	MI
2	1223G0001X	General Practice Dentistry	DDS105206	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	DDS105206	OTHER	CA	DENTAL BOARD OF CALIFORNIA

General Provider Information

NPI Number	:	1609223023
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH MARTIN FARKASH D.D.S.

Provider Business Mailing Address
First Line	:	28442 DRIVER AVE
Second Line	:
City	:	AGOURA HILLS
State	:	CA
Zip	:	91301-2616
Country	:	US
Telephone Number	:	818-963-0696
Fax Number	:

Provider Business Practice Location Address
First Line	:	4913 GOLDEN FOOTHILL PKWY
Second Line	:
City	:	EL DORADO HILLS
State	:	CA
Zip	:	95762-9632
Country	:	US
Telephone Number	:	530-556-4810
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/16/2016
Last Update Date	:	06/08/2023

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