Active NPI
Chadwick J. Harris, DMD
- Dentist
- Laurel, MS
National Provider Identifier
1992816201
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2943-96
- Practice address
- 701 N 16TH Ave
Laurel, MS 39440-3348 - Phone
- (601) 649-3344
- Fax
- (601) 649-3346
- NPI assigned
- Aug 31, 2006
- Sex
- Male
- 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 | 2943-96 | MS | Primary |
Addresses
Primary practice location
701 N 16TH Ave
Laurel, MS 39440-3348
Mailing address
15 Huckabee LN
Laurel, MS 39443-7508
Phone (601) 426-6864
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2943-96 | MS | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1992816201",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15 HUCKABEE LN",
"city": "LAUREL",
"state": "MS",
"postal_code": "394437508",
"telephone_number": "601-426-6864"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "701 N 16TH AVE",
"city": "LAUREL",
"state": "MS",
"postal_code": "394403348",
"telephone_number": "601-649-3344",
"fax_number": "601-649-3346"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRIS",
"first_name": "CHADWICK",
"middle_name": "J.",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MS",
"license": "2943-96",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Laurel, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.