Active NPI
Matthew Harrison, DDS
- General Practice Dentistry
- Charlottesville, VA
National Provider Identifier
1366860090
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 0401414460
- Practice address
- 2700 Hydraulic Rd
Charlottesville, VA 22901-8915 - Phone
- (434) 973-2968
- Fax
- (434) 973-0257
- NPI assigned
- Mar 31, 2014
- Last updated
- Mar 2, 2021
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 0401414460 | VA | Primary |
Addresses
Primary practice location
2700 Hydraulic Rd
Charlottesville, VA 22901-8915
Mailing address
2700 Hydraulic Rd
Charlottesville, VA 22901-8915
Phone (434) 973-2968
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151209001014 | VA | Order and Referring Only - Dentist | 6204055130 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0401414460 | VA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Matthew P Harrison DDS PLLC | General Practice | Current | Accepting new patients |
Locations
2700 Hydraulic Rd
Charlottesville, VA 22901
Phone (434) 973-2968
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Harrison Dental Associates
- General Practice Dentistry
- Charlottesville, VA
- NPI 1407536733
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1396224000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1614643200000",
"number": "1366860090",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2700 HYDRAULIC RD",
"city": "CHARLOTTESVILLE",
"state": "VA",
"postal_code": "229018915",
"telephone_number": "434-973-2968",
"fax_number": "434-973-0257"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2700 HYDRAULIC RD",
"city": "CHARLOTTESVILLE",
"state": "VA",
"postal_code": "229018915",
"telephone_number": "434-973-2968",
"fax_number": "434-973-0257"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRISON",
"first_name": "MATTHEW",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-03-31",
"last_updated": "2021-03-02",
"certification_date": "2021-03-02",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "VA",
"license": "0401414460",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Charlottesville, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 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.