Jacqueline Rochelle Harris

Primary specialty

DentistTaxonomy code 122300000X

License

DN1859155 Issued in MA

Practice address

45 Dimock St
Boston, MA 02119-1208

Phone

(612) 442-8800

Fax

(617) 442-4088

NPI assigned

May 24, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1621814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630368000000",
    "number": "1326613266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 GREAT RIVER RD APT 320",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021451220",
            "telephone_number": "770-296-0186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 DIMOCK ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021191208",
            "telephone_number": "612-442-8800",
            "fax_number": "617-442-4088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "JACQUELINE",
        "middle_name": "ROCHELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-24",
        "last_updated": "2021-08-31",
        "certification_date": "2021-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MA",
            "license": "DN1859155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Devon Abt Harris, MD
• Dwight Douglas Harris II
• Dynasty Harris
• Emily M Harris, MD
• Eva Harris, LICSW
• Jamie Harris, APRN
• Jason B Harris, MD
• Jay Harris, MD
• Jennifer Harris, MSW
• John McArthur Harris III, M.D.

• Dentist in Boston, MA
• Providers in Boston, MA by specialty
• Dentist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2021; 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.

Verify at the official NPI Registry.