David K. Harrison DDS PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12008577 Issued in IN

Legal business name

DAVID K. HARRISON DDS PC

Practice address

6412 Winchester Rd
Fort Wayne, IN 46819-1550

Phone

(260) 747-4747

Fax

(260) 747-4749

NPI assigned

Oct 17, 2006

Organization subpart

No

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

Authorized official

Name

David K Harrison

Title

Owner

Phone

(260) 747-4747

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361923200000",
    "number": "1831279447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6412 WINCHESTER RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468191550",
            "telephone_number": "260-747-4747",
            "fax_number": "260-747-4749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6412 WINCHESTER RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468191550",
            "telephone_number": "260-747-4747",
            "fax_number": "260-747-4749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID K. HARRISON DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-17",
        "last_updated": "2013-02-27",
        "status": "A",
        "authorized_official_last_name": "HARRISON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "260-747-4747"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12008577",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100079930",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• General Practice Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2013; 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.