Mark E Harris, DDS

Primary specialty

Public Health DentistryTaxonomy code 1223D0001X

License

51258 Issued in CA

Practice address

5925 Brockton Ave
Ste B
Riverside, CA 92506-7800

Phone

(951) 684-4988

Fax

(951) 684-4899

NPI assigned

Oct 27, 2005

Sex

Male

Sole proprietor

Yes

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

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Mark E Harris D D S Inc

  • Dental Clinic/Center
  • Riverside, CA
  • NPI 1023462330
  NPD (past) Authorized official

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

{
    "created_epoch": "1130371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187827200000",
    "number": "1508856840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5925 BROCKTON AVE",
            "address_2": "STE B",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925067800",
            "telephone_number": "951-684-4988",
            "fax_number": "951-684-4899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5925 BROCKTON AVE",
            "address_2": "STE B",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925067800",
            "telephone_number": "951-684-4988",
            "fax_number": "951-684-4899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "MARK",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-27",
        "last_updated": "2007-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "CA",
            "license": "51258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jude Harris, CPNP-PC
• Kameshia Laurice Harris
• Kara Harris
• Madison Harris
• Marcelus Harris
• Richard Ernest Harris, M.D.
• Shannon Renee Harris, LVN
• Shawn Harris
• Shea Harris
• Christine Harrison

• All providers in Riverside, CA
• Public Health Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2007; 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.

Verify at the official NPI Registry.