Active NPI
Donn William Harris, D.D.S.
- General Practice Dentistry
- Appleton, WI
National Provider Identifier
1720105422
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 3639
- Practice address
- 2115 E Evergreen Dr
Appleton, WI 54913-9001 - Phone
- (920) 734-2345
- Fax
- (920) 734-5651
- NPI assigned
- Mar 26, 2007
- 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 | 3639 | WI | Primary |
Addresses
Primary practice location
2115 E Evergreen Dr
Appleton, WI 54913-9001
Mailing address
3333 N Mayfair Rd Ste 311
Wauwatosa, WI 53222-3219
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161212000171 | WI | Order and Referring Only - Dentist | 5799065652 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3639 | WI | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dental Associates LTD of Wisconsin | General Practice | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174867200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1547596800000",
"number": "1720105422",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3333 N MAYFAIR RD STE 311",
"city": "WAUWATOSA",
"state": "WI",
"postal_code": "532223219"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2115 E EVERGREEN DR",
"city": "APPLETON",
"state": "WI",
"postal_code": "549139001",
"telephone_number": "920-734-2345",
"fax_number": "920-734-5651"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRIS",
"first_name": "DONN",
"middle_name": "WILLIAM",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-26",
"last_updated": "2019-01-16",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "WI",
"license": "3639",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Appleton, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2019; 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.