Active NPI
Jimmy Harden
- General Practice Dentistry
- Lake City, FL
National Provider Identifier
1609296995
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 1223G00001X
- Practice address
- 1283 SW Zesty Cir Apt 101
Lake City, FL 32025-0729 - Phone
- (386) 344-4321
- NPI assigned
- Apr 24, 2014
- Sex
- Male
- Sole proprietor
- No
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 | 1223G00001X | FL | Primary |
Addresses
Primary practice location
1283 SW Zesty Cir Apt 101
Lake City, FL 32025-0729
Mailing address
1283 SW Zesty Cir Apt 101
Lake City, FL 32025-0729
Phone (386) 344-4321
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 |
|---|---|---|---|
| 1223G00001X | FL | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1398297600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1398297600000",
"number": "1609296995",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1283 SW ZESTY CIR APT 101",
"city": "LAKE CITY",
"state": "FL",
"postal_code": "320250729",
"telephone_number": "386-344-4321"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1283 SW ZESTY CIR APT 101",
"city": "LAKE CITY",
"state": "FL",
"postal_code": "320250729",
"telephone_number": "386-344-4321"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARDEN",
"first_name": "JIMMY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-04-24",
"last_updated": "2014-04-24",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "FL",
"license": "1223G00001X",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake City, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.