Mark E Harris, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6822295 Issued in UT

Practice address

2274 N 400 E
Suite 204
North Ogden, UT 84414

Phone

(801) 399-0458

Fax

(801) 393-2212

NPI assigned

May 31, 2006

Last updated

Apr 16, 2009By the provider in NPPES

Sex

Male

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

Enrolled in UT

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

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.

• Cobble Creek Dental LLC

  • General Practice Dentistry
  • North Ogden, UT
  • NPI 1972868453
  NPD (past) Authorized official

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1239840000000",
    "number": "1669419701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2274 N 400 E",
            "address_2": "SUITE 204",
            "city": "NORTH OGDEN",
            "state": "UT",
            "postal_code": "84414",
            "telephone_number": "801-399-0458",
            "fax_number": "801-393-2212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2274 N 400 E",
            "address_2": "SUITE 204",
            "city": "NORTH OGDEN",
            "state": "UT",
            "postal_code": "84414",
            "telephone_number": "801-399-0458",
            "fax_number": "801-393-2212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "MARK",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-31",
        "last_updated": "2009-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "ID",
            "license": "D3622",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "6822295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Half Dental Ogden
• Half Dental Utah LLC
• Bradley Hansen, PT, DPT
• Heather Hansen, DMD
• Ryan Hardcastle
• Curtis M Healey, MD
• Trace R Hellstrom
• Dana Lee Hernandez
• Tami Hunter
• Ihc Health Services Inc (North Ogden Clinic - InstaCare)

• General Practice Dentistry in North Ogden, UT
• Providers in North Ogden, UT by specialty
• General Practice Dentistry in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2009; 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.