Active NPI
Gina Harris, DDS
- Dentist
- Memphis, TN
National Provider Identifier
1922480797
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 10072
- Practice address
- 775 E Brookhaven Cir
Memphis, TN 38117-4501 - Phone
- (901) 682-3100
- NPI assigned
- Jun 29, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 10072 | TN | Primary |
Addresses
Primary practice location
775 E Brookhaven Cir
Memphis, TN 38117-4501
Mailing address
775 E Brookhaven Cir
Memphis, TN 38117-4501
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160624000993 | TN | Order and Referring Only - Dentist | 6204127038 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10072 | TN | MD | Geriatric Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1435536000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1469145600000",
"number": "1922480797",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "775 E BROOKHAVEN CIR",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381174501"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "775 E BROOKHAVEN CIR",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381174501",
"telephone_number": "901-682-3100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRIS",
"first_name": "GINA",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-06-29",
"last_updated": "2016-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TN",
"license": "10072",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Memphis, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.