Harry E Jamison, DDS
Individual provider Active NPI Periodontics · Green Valley, AZ
NPI 1922012889 · NPPES record last updated May 17, 2024
Key facts
- NPI
- 1922012889
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Periodontics 1223P0300X
- License
- 1895 (AZ)
- Practice address
- 101 S Lacanada Drive
Suite 54
Green Valley, AZ 85614 - Phone
- (520) 625-2311
- Fax
- (520) 625-2090
- NPI assigned
- Jul 28, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
- Opted out of Medicare
- Yes, effective Jan 1, 2016 through Jan 1, 2028
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 1895 | AZ | Yes |
Addresses
Primary practice location
101 S Lacanada Drive
Suite 54
Green Valley, AZ 85614
Mailing address
101 54 S Lacanada Drive
Green Valley, AZ 85614
Phone (520) 625-2311
Other providers in Green Valley, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 17, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.