Douglas R Harty, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

12008501B Issued in IN

Practice address

2801 Fairview PL
Suite U
Greenwood, IN 46142-1310

Phone

(317) 881-1680

Fax

(317) 881-0603

NPI assigned

Aug 17, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NE

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

State licenses

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583712000000",
    "number": "1578676029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 FAIRVIEW PL",
            "address_2": "SUITE U",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461421310",
            "telephone_number": "317-881-1680",
            "fax_number": "317-881-0603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 FAIRVIEW PL",
            "address_2": "SUITE U",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461421310",
            "telephone_number": "317-881-1680",
            "fax_number": "317-881-0603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARTY",
        "first_name": "DOUGLAS",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-17",
        "last_updated": "2020-03-09",
        "certification_date": "2020-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12008501B",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100124790A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Isaac William Hartman, DO
• Jennifer Lee Hartman, PA-C
• Lindsey N Hartman, BCBA
• Morgan Nicole Hartman
• Susan E Hartman, MD
• Luke Douglas Harty, LCSW
• Regina R Harvey, O.D.
• Imran Hasanuddin, M.D.
• Zachary Michael Hasenwinkel, PA
• Junaid Hasnain

• Dentist in Greenwood, IN
• Providers in Greenwood, IN by specialty
• Dentist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2020; 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.