Peter A Harris, DDS

Primary specialty

Public Health DentistryTaxonomy code 1223D0001X

License

2901014030 Issued in MI

Practice address

12251 James St
Suite 400
Holland, MI 49424-9675

Phone

(616) 393-5694

Fax

(616) 393-5643

NPI assigned

Oct 16, 2006

Last updated

Jan 9, 2012By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326067200000",
    "number": "1063592814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12251 JAMES ST",
            "address_2": "SUITE 400",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494249675",
            "telephone_number": "616-393-5694",
            "fax_number": "616-393-5643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12251 JAMES ST",
            "address_2": "SUITE 400",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494249675",
            "telephone_number": "616-393-5694",
            "fax_number": "616-393-5643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "PETER",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2012-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "MI",
            "license": "2901014030",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "744805457",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lorraine Harper, LMSW
• Richard R Harper, MD
• Bonnie Harris-Moore
• Angela J Harris, DDS
• Mackenzie Harris, DPT
• William Carl Harris, MD
• Elizabeth R Harsevoort, LMSW
• Roland C Hart, LLP
• Nicole Francine Hartley
• Brittany Ann Hartman

• Public Health Dentistry in Holland, MI
• Providers in Holland, MI by specialty
• Public Health Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.