Jesse Bluford Harris, D.D.S., M.S.D.

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

0401411059 Issued in VA

Practice address

9102 Rutland Greens Way
A
Mechanicsville, VA 23116

Phone

(804) 559-3636

Fax

(804) 789-8426

NPI assigned

Oct 4, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349654400000",
    "number": "1851487433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9102 RUTLAND GREENS WAY",
            "address_2": "A",
            "city": "MECHANICSVILLE",
            "state": "VA",
            "postal_code": "23116",
            "telephone_number": "804-559-3636",
            "fax_number": "804-789-8426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9102 RUTLAND GREENS WAY",
            "address_2": "A",
            "city": "MECHANICSVILLE",
            "state": "VA",
            "postal_code": "23116",
            "telephone_number": "804-559-3636",
            "fax_number": "804-789-8426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "JESSE",
        "middle_name": "BLUFORD",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2012-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "VA",
            "license": "0401411059",
            "primary": true
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "AK",
            "license": "1223",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles Winston Harrill, OD
• Amy Lynn Harris, PHARMD
• Barton Harris, MD
• Carrie Marie Harris
• Eboni Harris
• Lilly Harris
• Ashley Anne Harwood, D.P.T.
• Rosanna Hastings, NP
• John Woodruff Hawkins, MD
• Jonathon Aron Hawkins

• Endodontics in Mechanicsville, VA
• Providers in Mechanicsville, VA by specialty
• Endodontics in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2012; 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.