Active NPI
Credle Harris, DMD
- General Practice Dentistry
- Chapel Hill, NC
National Provider Identifier
1063893345
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 10040
- Practice address
- 1721 E Franklin St
Chapel Hill, NC 27514-5854 - Phone
- (919) 967-9291
- NPI assigned
- Jun 12, 2015
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 10040 | NC | Primary |
Addresses
Primary practice location
1721 E Franklin St
Chapel Hill, NC 27514-5854
Mailing address
700 Durant St Apt 304
Chapel Hill, NC 27517-7361
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 |
|---|---|---|---|
| 10040 | NC | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1434067200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1434067200000",
"number": "1063893345",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "700 DURANT ST APT 304",
"city": "CHAPEL HILL",
"state": "NC",
"postal_code": "275177361"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1721 E FRANKLIN ST",
"city": "CHAPEL HILL",
"state": "NC",
"postal_code": "275145854",
"telephone_number": "919-967-9291"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRIS",
"first_name": "CREDLE",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-06-12",
"last_updated": "2015-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NC",
"license": "10040",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chapel Hill, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.