Active NPI
David Harris, DDS
- Dentist
- Ardmore, OK
National Provider Identifier
1053516781
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 4190
- Practice address
- 2510 Chickasaw Blvd
Ardmore, OK 73401-1341 - Phone
- (580) 226-8181
- Fax
- (580) 226-5471
- NPI assigned
- Jun 21, 2007
- 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 | 4190 | OK | Primary |
Addresses
Primary practice location
2510 Chickasaw Blvd
Ardmore, OK 73401-1341
Mailing address
1921 Stonecipher Blvd
Ada, OK 74820
Phone (580) 421-4570
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1304190 | Medicaid | OK |
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 |
|---|---|---|---|
| 4190 | OK | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1182384000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1315526400000",
"number": "1053516781",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1921 STONECIPHER BLVD",
"city": "ADA",
"state": "OK",
"postal_code": "74820",
"telephone_number": "580-421-4570",
"fax_number": "580-421-6283"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2510 CHICKASAW BLVD",
"city": "ARDMORE",
"state": "OK",
"postal_code": "734011341",
"telephone_number": "580-226-8181",
"fax_number": "580-226-5471"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRIS",
"first_name": "DAVID",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-06-21",
"last_updated": "2011-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "OK",
"license": "4190",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1304190",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ardmore, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.