Jennifer Elizabeth Harrison, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D12108 Issued in MN

Practice address

20171 Icenic TRL
Lakeville, MN 55044-7708

Phone

(952) 469-3300

NPI assigned

Sep 1, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

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 and National Provider Directory roles.

• Lakeville Dental Associates, P.a.

  • Dental Clinic/Center
  • Lakeville, MN
  • NPI 1871697805
  NPD (past)
• Lakeville Dental Associates, PA

  • General Practice Dentistry
  • Lakeville, MN
  • NPI 1053614867
  NPD (past)

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318809600000",
    "number": "1700998929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20171 ICENIC TRL",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550447708",
            "telephone_number": "952-469-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20171 ICENIC TRL",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550447708",
            "telephone_number": "952-469-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRISON",
        "first_name": "JENNIFER",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-01",
        "last_updated": "2011-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D12108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Loren Lee Hanson, OD
• Ahlaam Harbi
• Blesson Harmon
• Harmony Behavioral Therapy LLC
• Brian Thomas Harrison, DDS
• John L Harrison, DDS
• Naomi Carolyn Haskins, MSW, LICSW
• Abdiladif Hassan
• Abdinasir Abdikarim Hassan
• Seth Havens

• General Practice Dentistry in Lakeville, MN
• Providers in Lakeville, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2011; 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.