Active NPI
Conrad Wayne Harris, DDS
- General Practice Dentistry
- Washington, DC
National Provider Identifier
1265674055
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DEN4740
- Practice address
- 4000 14TH St NW
Washington, DC 20011-5524 - Phone
- (202) 726-3760
- Fax
- (202) 726-3760
- NPI assigned
- Mar 25, 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DEN4740 | DC | Primary |
Addresses
Primary practice location
4000 14TH St NW
Washington, DC 20011-5524
Mailing address
4000 14TH St NW
Washington, DC 20011-5524
Phone (202) 726-3760
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 |
|---|---|---|---|
| DEN4740 | DC | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1237939200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1237939200000",
"number": "1265674055",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4000 14TH ST NW",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200115524",
"telephone_number": "202-726-3760",
"fax_number": "202-726-3760"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4000 14TH ST NW",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200115524",
"telephone_number": "202-726-3760",
"fax_number": "202-726-3760"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRIS",
"first_name": "CONRAD",
"middle_name": "WAYNE",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-03-25",
"last_updated": "2009-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "DC",
"license": "DEN4740",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Washington, DC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.