Active NPI
Ethan Daniel Harris, D.M.D.
- Dentist
- San Ramon, CA
National Provider Identifier
1255451266
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 21390
- Practice address
- 2301 Camino Ramon Ste 294
San Ramon, CA 94583-4440 - Phone
- (925) 557-7022
- NPI assigned
- Mar 31, 2007
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 21390 | MA | Primary |
Addresses
Primary practice location
2301 Camino Ramon Ste 294
San Ramon, CA 94583-4440
Mailing address
2301 Camino Ramon Ste 294
San Ramon, CA 94583-4440
Phone (925) 557-7022
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21390 | MA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cambridge Public Health Commission | Past | Accepting new patients | |
| Cambridge Public Health Commission | Past | Accepting new patients | |
| Ethan Harris DMD, Inc | Past | Accepting new patients |
Organizations & group practices 3
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
- San Ramon, CA
- NPI 1528504974
-
- General Acute Care Hospital
- Cambridge, MA
- NPI 1487603585
-
- General Acute Care Hospital
- Cambridge, MA
- NPI 1932313228
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175299200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1482105600000",
"number": "1255451266",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2301 CAMINO RAMON STE 294",
"city": "SAN RAMON",
"state": "CA",
"postal_code": "945834440",
"telephone_number": "925-557-7022"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2301 CAMINO RAMON STE 294",
"city": "SAN RAMON",
"state": "CA",
"postal_code": "945834440",
"telephone_number": "925-557-7022"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRIS",
"first_name": "ETHAN",
"middle_name": "DANIEL",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-31",
"last_updated": "2016-12-19",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MA",
"license": "21390",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Ramon, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.