Stacie Lynne Harris, RDH

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

License

21363 Issued in TX

Practice address

930 S Alamo St
San Antonio, TX 78205-3419

Phone

(210) 227-0101

NPI assigned

Jan 12, 2018

Last updated

Mar 17, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• I SDG, PLLC

  dba Southtown Dental Group

  • General Practice Dentistry
  • San Antonio, TX
  • NPI 1366533747
  NPD (past)

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

{
    "created_epoch": "1515715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1619485554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3015 LAKE MEADOW ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782222425",
            "telephone_number": "210-367-4729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 S ALAMO ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782053419",
            "telephone_number": "210-227-0101"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7870 Broadway St",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782092561",
            "country_code": "US",
            "telephone_number": "210-829-7826",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "STACIE",
        "middle_name": "LYNNE",
        "credential": "RDH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-12",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "TX",
            "license": "21363",
            "primary": true
        },
        {
            "code": "126800000X",
            "taxonomy_group": "",
            "desc": "Dental Assistant",
            "state": "TX",
            "license": "37325",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sabrina Denise Harris, M.D.
• Samantha Harris, MPH, RDN, LD
• Scott L. Harris, M.D.
• Shandra Harris, M.ED
• Shay Ashton Harris, PHD, LPC
• Syerra Harris, PA-C
• Tatyana Shae Harris
• Yesica Harris
• Brady Mitchell Harrison, PA
• Cameron William Harrison, M.D.

• Dental Hygienist in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Dental Hygienist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.