Provider Demographics
NPI:1457376196
Name:HARRIS, JAMES PATRICK (DDS)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:PATRICK
Last Name:HARRIS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:809 SINGLETON BLVD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75212-4014
Mailing Address - Country:US
Mailing Address - Phone:214-571-6152
Mailing Address - Fax:214-651-9514
Practice Address - Street 1:809 SINGLETON BLVD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75212-4014
Practice Address - Country:US
Practice Address - Phone:214-651-8739
Practice Address - Fax:214-379-2281
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX147621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXG60091-01OtherDELTA DENTAL PROVIDER ID
TX14762OtherSTATE LICENSE #
TX812460OtherBLUE CROSS & BLUE SHIELD
TXT13713Medicare UPIN
TX14762OtherSTATE LICENSE #