Mark Anthony Harris, DENTAL ASSISTANT

Primary specialty

Dental AssistantTaxonomy code 126800000X

Practice address

10590 Enduring Freedom Dr
Fort Drum, NY 13602-5503

Phone

(315) 772-6217

NPI assigned

Nov 19, 2021

Last updated

Jun 17, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1637280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655424000000",
    "number": "1316604713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10590 ENDURING FREEDOM DR",
            "city": "FORT DRUM",
            "state": "NY",
            "postal_code": "136025503",
            "telephone_number": "315-772-6217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10590 ENDURING FREEDOM DR",
            "city": "FORT DRUM",
            "state": "NY",
            "postal_code": "136025503",
            "telephone_number": "315-772-6217"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1667 Cochrane Cir Bldg 7495",
            "address_purpose": "LOCATION",
            "city": "Fort Carson",
            "state": "CO",
            "postal_code": "809134603",
            "country_code": "US",
            "telephone_number": "719-526-5537",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "MARK",
        "middle_name": "ANTHONY",
        "credential": "DENTAL ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-11-19",
        "last_updated": "2022-06-17",
        "certification_date": "2022-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "126800000X",
            "taxonomy_group": "",
            "desc": "Dental Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Zachary Haney, DO
• Joel William Hanna, P.T.
• Stephen M. Hanna, RPA-C
• Nicole Dorio Hardenburgh, PHD
• Chelsea Elizabeth Harris, D.M.D.
• Catherine L Harruff, LPCC
• Jeffrey Glen Hart, PA-C
• Sarah D Hasko, MSN, FNP-C
• John Hauck, PA-C
• Jessica Parker Hayden, PHYSICIAN ASSISTANT

• Dental Assistant in Fort Drum, NY
• Providers in Fort Drum, NY by specialty
• Dental Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.