Individual provider Active NPI

Harvey Lane Harris Jr., D.D.S.

  • General Practice Dentistry
  • Raleigh, NC
National Provider Identifier
1427100593
Registry record updated Jul 23, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7986 Issued in NC
Practice address
20 Enterprise St
Suite 1
Raleigh, NC 27607-7375
Phone
(919) 828-3775
NPI assigned
Jan 17, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 7986 NC Primary

Addresses

Primary practice location

20 Enterprise St
Suite 1
Raleigh, NC 27607-7375

Mailing address

104 Juniper Creek Blvd
Pinehurst, NC 28374-6806

Other identifiers 1

IdentifierTypeStateIssuer
5901114MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20160617000495 NC Order and Referring Only - DentistPractitioner - Dentist 1355632613

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7986NCMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Harvey Lane Harris Jr DDS PLLC General Practice CurrentSince Sep 10, 2023 Accepting new patients
Robert L Williamson III DDS PA General Practice Past Accepting new patients

Locations

1317 Central Dr
Sanford, NC 27330
Phone (919) 775-2522

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185148800000",
    "number": "1427100593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 JUNIPER CREEK BLVD",
            "city": "PINEHURST",
            "state": "NC",
            "postal_code": "283746806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 ENTERPRISE ST",
            "address_2": "SUITE 1",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276077375",
            "telephone_number": "919-828-3775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "HARVEY",
        "middle_name": "LANE",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-17",
        "last_updated": "2007-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "7986",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5901114",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.