Mark Floyd Harris, D.D.S.,P.A

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3504 Issued in AR

Practice address

2001 N Green Acres Rd
Fayetteville, AR 72703-2619

Phone

(479) 521-6365

Fax

(479) 521-6364

NPI assigned

Jul 26, 2006

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

Medicare fee-for-service enrollment

Enrolled in MO

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

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286236800000",
    "number": "1225052392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 N GREEN ACRES RD",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727032619",
            "telephone_number": "479-521-6365",
            "fax_number": "479-521-6364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 N GREEN ACRES RD",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727032619",
            "telephone_number": "479-521-6365",
            "fax_number": "479-521-6364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "MARK",
        "middle_name": "FLOYD",
        "name_prefix": "Dr.",
        "credential": "D.D.S.,P.A",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2010-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "3504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Colten Harris
• David Harris, MHPP
• David Michael Harris
• Grant Michael Harris
• Hannah Harris, MS, PT
• Murray T Harris, MD
• Robert Charles Harris, DDS
• Tammi Lynn Harris, LCSW
• Thomas E. Harris, M.D.
• Timneshia Harris

• General Practice Dentistry in Fayetteville, AR
• Providers in Fayetteville, AR by specialty
• General Practice Dentistry in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2010; 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.