Active NPI
Anthony D Harless, DDS
- General Practice Dentistry
- West Union, OH
National Provider Identifier
1134224710
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 21275
- Practice address
- 818 NE Main St
West Union, OH 45693-1111 - Phone
- (937) 544-3239
- Fax
- (937) 544-7165
- NPI assigned
- Sep 14, 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 21275 | OH | Primary |
Addresses
Primary practice location
818 NE Main St
West Union, OH 45693-1111
Mailing address
818 NE Main St
West Union, OH 45693-1111
Phone (937) 544-3239
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2196832 | Medicaid | OH |
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 |
|---|---|---|---|
| 21275 | OH | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| West Union Family Dental, Surya Pamulapati, BDS, MPH, Aegd, LLC | General Practice | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Practice Dentistry
- West Union, OH
- NPI 1518606698
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158192000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1134224710",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "818 NE MAIN ST",
"city": "WEST UNION",
"state": "OH",
"postal_code": "456931111",
"telephone_number": "937-544-3239",
"fax_number": "937-544-7165"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "818 NE MAIN ST",
"city": "WEST UNION",
"state": "OH",
"postal_code": "456931111",
"telephone_number": "937-544-3239",
"fax_number": "937-544-7165"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARLESS",
"first_name": "ANTHONY",
"middle_name": "D",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-14",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "OH",
"license": "21275",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2196832",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in West Union, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.