Active NPI
Brandon Harris
- General Practice Dentistry
- Sun City, AZ
National Provider Identifier
1467010991
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- D010346
- Practice address
- 10503 W Thunderbird Blvd Ste 371
Sun City, AZ 85351-2721 - Phone
- (400) 977-4001
- NPI assigned
- May 30, 2019
- Sex
- Male
- Sole proprietor
- Yes
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 | D010346 | AZ | Primary |
Addresses
Primary practice location
10503 W Thunderbird Blvd Ste 371
Sun City, AZ 85351-2721
Mailing address
4954 W Jeremy Dr
Glendale, AZ 85308-1405
Phone (949) 246-3820
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D010346 | AZ | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1559174400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1562803200000",
"number": "1467010991",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4954 W JEREMY DR",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853081405",
"telephone_number": "949-246-3820"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10503 W THUNDERBIRD BLVD STE 371",
"city": "SUN CITY",
"state": "AZ",
"postal_code": "853512721",
"telephone_number": "400-977-4001"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRIS",
"first_name": "BRANDON",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-05-30",
"last_updated": "2019-07-11",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist, General Practice",
"state": "AZ",
"license": "D010346",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sun City, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.