Organization Active NPI

Thomas J. Harmon D.D.S.

  • General Practice Dentistry
  • Grand Rapids, MI
National Provider Identifier
1396090619
Registry record updated Aug 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
THOMAS J. HARMON D.D.S.
Practice address
3575 Lake Eastbrook Blvd SE
Grand Rapids, MI 49546-5934
Phone
(616) 949-2650
Fax
(616) 222-0747
NPI assigned
Jul 24, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2012

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

Authorized official

Name
Dr. Thomas J Harmon, D.D.S.NPI 1790874204
Title
Owner
Phone
(616) 949-2650

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

3575 Lake Eastbrook Blvd SE
Grand Rapids, MI 49546-5934

Mailing address

3575 Lake Eastbrook Blvd SE
Grand Rapids, MI 49546-5934
Phone (616) 949-2650

Other identifiers 1

IdentifierTypeStateIssuer
4055750MedicaidMI

National Provider Directory

National Provider Directory

Locations

3575 Lake Eastbrook Blvd SE
Grand Rapids, MI 49546
Phone (616) 949-2650

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1343088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1344297600000",
    "number": "1396090619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3575 LAKE EASTBROOK BLVD SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495465934",
            "telephone_number": "616-949-2650",
            "fax_number": "616-222-0747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3575 LAKE EASTBROOK BLVD SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495465934",
            "telephone_number": "616-949-2650",
            "fax_number": "616-222-0747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS J. HARMON D.D.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-24",
        "last_updated": "2012-08-07",
        "status": "A",
        "authorized_official_last_name": "HARMON",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "616-949-2650",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4055750",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2012; 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.