Individual provider Active NPI

Andras G Haris, DMD

  • General Practice Dentistry
  • Bala Cynwyd, PA
National Provider Identifier
1295937779
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS017221L Issued in PA
Practice address
101 Bala Ave
Bala Cynwyd, PA 19004-3307
Phone
(610) 664-5658
Fax
(610) 667-2840
NPI assigned
Jun 5, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DS017221L PA Primary

Addresses

Primary practice location

101 Bala Ave
Bala Cynwyd, PA 19004-3307

Mailing address

101 Bala Ave
Bala Cynwyd, PA 19004-3307
Phone (610) 664-5658

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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

Enrollment IDStateProvider typePAC IDDetails
I20170209000021 PA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 9032492418

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DS017221LPAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1181001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295937779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 BALA AVE",
            "city": "BALA CYNWYD",
            "state": "PA",
            "postal_code": "190043307",
            "telephone_number": "610-664-5658",
            "fax_number": "610-667-2840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 BALA AVE",
            "city": "BALA CYNWYD",
            "state": "PA",
            "postal_code": "190043307",
            "telephone_number": "610-664-5658",
            "fax_number": "610-667-2840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARIS",
        "first_name": "ANDRAS",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS017221L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bala Cynwyd, PA

Sources for this page

Verify at the official NPI Registry.