Active NPI
Benjamin Rex Harrison, DMD
- Dentist
- Panama City, FL
National Provider Identifier
1003449224
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN24897
- Practice address
- 1012 W 11TH St
Panama City, FL 32401-2042 - Phone
- (850) 819-1045
- NPI assigned
- Feb 17, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DN24897 | FL | Primary |
Addresses
Primary practice location
1012 W 11TH St
Panama City, FL 32401-2042
Mailing address
337 Bunkers Cove Rd
Panama City, FL 32401-3911
Phone (850) 819-1045
Other practice location 1
1120 15th St # Gc5110
Augusta, GA 30912-0004
Phone (706) 721-2251
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
| License | State | Type | Specialty |
|---|---|---|---|
| DN24897 | FL | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Harrison Dental Associates | Current | Accepting new patients |
Locations
1012 W 11th St
Panama City, FL 32401
Phone (850) 763-6782
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 and National Provider Directory roles.
-
- Dental Clinic/Center
- Panama City, FL
- NPI 1164095675
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1581897600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638230400000",
"number": "1003449224",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "337 BUNKERS COVE RD",
"city": "PANAMA CITY",
"state": "FL",
"postal_code": "324013911",
"telephone_number": "850-819-1045"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1012 W 11TH ST",
"city": "PANAMA CITY",
"state": "FL",
"postal_code": "324012042",
"telephone_number": "850-819-1045"
}
],
"practiceLocations": [
{
"address_1": "1120 15th St # Gc5110",
"address_purpose": "LOCATION",
"city": "Augusta",
"state": "GA",
"postal_code": "309120004",
"country_code": "US",
"telephone_number": "706-721-2251",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HARRISON",
"first_name": "BENJAMIN",
"middle_name": "REX",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-02-17",
"last_updated": "2021-11-30",
"certification_date": "2021-06-02",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "FL",
"license": "DN24897",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Panama City, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.