Organization Active NPI

Matthew B. Harrison, DDS, PA

  • General Practice Dentistry
  • Rogers, AR
National Provider Identifier
1609996545
Registry record updated Nov 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3408 Issued in AR
Legal business name
MATTHEW B. HARRISON, DDS, PA
Practice address
1107 W Elm St
Rogers, AR 72756-4235
Phone
(479) 636-1194
Fax
(479) 636-8549
NPI assigned
Mar 31, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2011

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

Authorized official

Name
Laura Harrison
Title
Owner
Phone
(479) 636-1194

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 3408 AR Primary

Addresses

Primary practice location

1107 W Elm St
Rogers, AR 72756-4235

Mailing address

1107 W Elm St
Rogers, AR 72756-4235
Phone (479) 636-1194

National Provider Directory

National Provider Directory

Locations

1107 W Elm St
Rogers, AR 72756
Phone (479) 636-1194

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1175299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320192000000",
    "number": "1609996545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1107 W ELM ST",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727564235",
            "telephone_number": "479-636-1194",
            "fax_number": "479-636-8549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1107 W ELM ST",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727564235",
            "telephone_number": "479-636-1194",
            "fax_number": "479-636-8549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATTHEW B. HARRISON, DDS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-31",
        "last_updated": "2011-11-02",
        "status": "A",
        "authorized_official_last_name": "HARRISON",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "479-636-1194"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "3408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rogers, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.