Active NPI
Tiara Harrison
- Dentist
- SE, DC
National Provider Identifier
1013397454
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 0401414821
- Practice address
- 1100 Alabama Ave.
SE, DC 20023 - Phone
- (202) 299-5178
- NPI assigned
- Jun 1, 2015
- Last updated
- Jun 1, 2015
- Sex
- Female
- Sole proprietor
- Yes
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 | 0401414821 | VA | Primary |
Addresses
Primary practice location
1100 Alabama Ave.
SE, DC 20023
Mailing address
3709 Julep Dr
South Chesterfield, VA 23834-5635
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250328002370 | VA | Order and Referring Only - Dentist | 4284157322 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/HEGDAA/Endpoint/HEGDAA
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1433116800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1433116800000",
"number": "1013397454",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3709 JULEP DR",
"city": "SOUTH CHESTERFIELD",
"state": "VA",
"postal_code": "238345635"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 ALABAMA AVE.",
"city": "SE",
"state": "DC",
"postal_code": "20023",
"telephone_number": "202-299-5178"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRISON",
"first_name": "TIARA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-06-01",
"last_updated": "2015-06-01",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "VA",
"license": "0401414821",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in SE, DC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.