Active NPI
Jerry D Harl, DDS
- Orthodontics and Dentofacial Orthopedics Dentistry
- Osage Beach, MO
National Provider Identifier
1023178571
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 010099
- Practice address
- 5816 Hwy 54
Suite 107
Osage Beach, MO 65065 - Phone
- (573) 348-3127
- Fax
- (573) 348-1910
- NPI assigned
- Dec 12, 2006
- 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 |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 010099 | MO | Primary |
Addresses
Primary practice location
5816 Hwy 54
Suite 107
Osage Beach, MO 65065
Mailing address
802 Stewart Road
Columbia, MO 65203
Phone (573) 875-4143
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 |
|---|---|---|---|
| 010099 | MO | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165881600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1023178571",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "802 STEWART ROAD",
"city": "COLUMBIA",
"state": "MO",
"postal_code": "65203",
"telephone_number": "573-875-4143",
"fax_number": "573-449-9200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5816 HWY 54",
"address_2": "SUITE 107",
"city": "OSAGE BEACH",
"state": "MO",
"postal_code": "65065",
"telephone_number": "573-348-3127",
"fax_number": "573-348-1910"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARL",
"first_name": "JERRY",
"middle_name": "D",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "MO",
"license": "010099",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Osage Beach, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.