Individual provider Active NPI

Andrea Harrison, D.M.D.

  • Dentist
  • Marlborough, MA
National Provider Identifier
1174921027
Registry record updated Dec 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN1856781 Issued in MA
Practice address
116 Main St Ste 1
Marlborough, MA 01752-3811
Phone
(508) 485-2001
Fax
(508) 485-2201
NPI assigned
Dec 9, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN1856781 MA Primary

Addresses

Primary practice location

116 Main St Ste 1
Marlborough, MA 01752-3811

Mailing address

116 Main St Ste 1
Marlborough, MA 01752-3811
Phone (508) 485-2001

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

LicenseStateTypeSpecialty
DN1856781MAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1418083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418083200000",
    "number": "1174921027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 MAIN ST STE 1",
            "city": "MARLBOROUGH",
            "state": "MA",
            "postal_code": "017523811",
            "telephone_number": "508-485-2001",
            "fax_number": "508-485-2201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 MAIN ST STE 1",
            "city": "MARLBOROUGH",
            "state": "MA",
            "postal_code": "017523811",
            "telephone_number": "508-485-2001",
            "fax_number": "508-485-2201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRISON",
        "first_name": "ANDREA",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-09",
        "last_updated": "2014-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DN1856781",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marlborough, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2014; 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.