Kelly Lynn Harris, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

17918 Issued in FL

Practice address

700 Nokomis Ave S
Venice, FL 34285-3419

Phone

(941) 484-3551

NPI assigned

Jun 25, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1182729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104022276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 NOKOMIS AVE S",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342853419",
            "telephone_number": "941-484-3551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 NOKOMIS AVE S",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342853419",
            "telephone_number": "941-484-3551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "KELLY",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "17918",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Harmony Counseling Associates LLC
• Harold J Kaplan MD PA
• Carolyn Caswell Harrington, RD, LDN, CDE
• Chaz Joseph Harris
• Joycelynn Harris, APRN
• Melinda Beth Hart, MD
• Gregg G. Hassler Jr., D.M.D.
• Ki M Hassler, D.O.
• Tara Lynnette Hastings
• Chasie L. Haupt, PA

• General Practice Dentistry in Venice, FL
• Providers in Venice, FL by specialty
• General Practice Dentistry in Florida

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.