Individual provider Active NPI

Phillip Harvey

  • Dentist
  • Lackland AFB, TX
National Provider Identifier
1760462949
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
60356 Issued in KS
Practice address
2200 Bergquist Dr
Attn: Credentials (CMC
Lackland a F B, TX 78236-9908
Phone
(210) 292-6707
NPI assigned
Jan 22, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 60356 KS Primary

Addresses

Primary practice location

2200 Bergquist Dr
Attn: Credentials (CMC
Lackland a F B, TX 78236-9908

Mailing address

9914 Ramblin River Rd
San Antonio, TX 78251-4310

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141001001781 KS Order and Referring Only - Maxillofacial SurgeryPractitioner - Maxillofacial Surgery 7315167053

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Oral Surgery Kansas, LC 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1137888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1760462949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9914 RAMBLIN RIVER RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782514310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 BERGQUIST DR",
            "address_2": "ATTN: CREDENTIALS (CMC",
            "city": "LACKLAND A F B",
            "state": "TX",
            "postal_code": "782369908",
            "telephone_number": "210-292-6707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARVEY",
        "first_name": "PHILLIP",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-22",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KS",
            "license": "60356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lackland AFB, TX

Sources for this page

Verify at the official NPI Registry.