Active NPI
Trevor L Harrison, DDS
- Dentist
- Dallas, TX
National Provider Identifier
1245465707
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 24598
- Practice address
- 1527 Seegar St
Dallas, TX 75215-2002 - Phone
- (210) 601-0775
- NPI assigned
- May 27, 2009
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Dentist | 122300000X | 24598 | TX | Primary |
Addresses
Primary practice location
1527 Seegar St
Dallas, TX 75215-2002
Mailing address
1527 Seegar St
Dallas, TX 75215-2002
Phone (210) 601-0775
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150811005378 | TX | Order and Referring Only - Oral Surgery | 3476868076 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24598 | TX | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1243382400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1243382400000",
"number": "1245465707",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1527 SEEGAR ST",
"city": "DALLAS",
"state": "TX",
"postal_code": "752152002",
"telephone_number": "210-601-0775"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1527 SEEGAR ST",
"city": "DALLAS",
"state": "TX",
"postal_code": "752152002",
"telephone_number": "210-601-0775"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRISON",
"first_name": "TREVOR",
"middle_name": "L",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-05-27",
"last_updated": "2009-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "24598",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2009; 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.