Jay M. Harris

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

1641 Issued in ID

Practice address

3815 Washington Pkwy
Idaho Falls, ID 83404-7591

Phone

(208) 529-4500

Fax

(208) 524-6248

NPI assigned

Jan 31, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Harris Dental

  • General Practice Dentistry
  • Idaho Falls, ID
  • NPI 1760686679
  NPD (past) Authorized official
• Harris & Allen Dental

  • General Practice Dentistry
  • Idaho Falls, ID
  • NPI 1942508361
  NPD (past)

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1851438709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3815 WASHINGTON PKWY",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047591",
            "telephone_number": "208-529-4500",
            "fax_number": "208-524-6248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3815 WASHINGTON PKWY",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047591",
            "telephone_number": "208-529-4500",
            "fax_number": "208-524-6248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "JAY",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-31",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "1641",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER NUMBER",
            "identifier": "852027",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Aaron A Harris, PHD
• Ben Harris, MSW
• Duncan Dwaynne Harris, M.D.
• Hailey Decalyn Harris
• James B Harris, MD
• Kelly D Harris, D.C.
• Kolton Harris
• Michael J Harris, MSW, PH.D
• Michael Thomas Harris, MD
• Robert T Harris, MD

• General Practice Dentistry in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• General Practice Dentistry in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.