Provider Demographics
NPI:1235653320
Name:HARVEY, JARED MICHAEL (DDS, MS)
Entity Type:Individual
Prefix:
First Name:JARED
Middle Name:MICHAEL
Last Name:HARVEY
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:650 BEEBALM LN STE 265
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75040-2955
Mailing Address - Country:US
Mailing Address - Phone:972-272-6543
Mailing Address - Fax:
Practice Address - Street 1:650 BEEBALM LN STE 265
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75040-2955
Practice Address - Country:US
Practice Address - Phone:972-272-6543
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-31
Last Update Date:2021-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX334091223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics