Jacob Edward Harrison, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN26041 Issued in FL

Practice address

1012 W 11TH St
Panama City, FL 32401-2042

Phone

(850) 763-6782

NPI assigned

Jun 22, 2021

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

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Harrison Dental Associates

  • Dental Clinic/Center
  • Panama City, FL
  • NPI 1164095675
  NPD

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

{
    "created_epoch": "1624320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624320000000",
    "number": "1386213486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1012 W 11TH ST",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324012042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1012 W 11TH ST",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324012042",
            "telephone_number": "850-763-6782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRISON",
        "first_name": "JACOB",
        "middle_name": "EDWARD",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-22",
        "last_updated": "2021-06-22",
        "certification_date": "2021-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN26041",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shawn Harris, MT
• Tiffany Fontaine Harris, M.D.
• Wayne Harris
• Harrison Dental Associates
• Benjamin Rex Harrison, DMD
• Linda Buchanan Harrison
• Rex Edward Harrison, DMD
• Debra Ann Hartley, LMHC
• Deanna Hartynyk
• Aimee Hartzog

• General Practice Dentistry in Panama City, FL
• Providers in Panama City, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2021; 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.