DR. JODY SCOTT HARRISON (NPI# 1285855809) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285855809 |
| Entity Type | Individual |
| Full Name | DR. JODY SCOTT HARRISON |
| Credential | DDS |
| Practice Address |
4700 Las Vegas Blvd Nellis Afb NV 89191-6601 |
| Mailing Address |
4700 Las Vegas Blvd N Nellis Afb NV 89191-6600 |
| Practice Telephone | 7026533148 |
| Mailing Telephone | 7026533148 |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2014-02-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
21129 | TX | Dental Providers |
| Street Address |
4700 LAS VEGAS BLVD |
| City | NELLIS AFB |
| State | NV |
| Zip Code | 89191-6601 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932526415 | Andrew Pan | Ophthalmology | 4700 Las Vegas Blvd, Nellis Afb, NV 89191 | 2014-03-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225662687 | Ashley Raye Roth-garcia | Student in an Organized Health Care Education/Training Program | 99th Medical Group 4700 Las Vegas Blvd North, Nellis Afb, NV 89191 | 2020-02-25 |
| 1427553734 | Christopher Robert Weisgarber | Student in an Organized Health Care Education/Training Program | Mike O'callaghan Military Medical Center, 4700 Las Vegas Blvd North Bldg 1300, Las Vegas, NV 89191 | 2018-03-28 |
| 1912345448 | Austin Joseph Ladner | Dentist | 99th Air Base Wing Public Affairs, Fpo, AA 89191 | 2013-06-06 |
| 1528329018 | Mayer M Jeppson | Psychologist | 4700 Las Vegas Blvd. N, Nellis Afb, NV 89191 | 2012-05-31 |
| 1255560462 | Jordan Lawrence | Military Health Care Provider | 1579 Malmstrom Avenue, Nellis Afb, NV 89191 | 2009-07-09 |
| 1225263072 | Adrienne L Clark | Military Health Care Provider | 5154 Ellsworth Ave, Suite 61690, Las Vegas, NV 89191 | 2009-05-22 |
| 1568634335 | Eleanor C Basilio | Registered Nurse | 4700 Las Vegas Blvd., Nellis Afb, NV 89191 | 2008-04-01 |
| 1316137037 | Sarah Rachel Glick | Pediatrics | 4700 N. Las Vegas Blvd., Mike O'callaghan Federal Medical Center, 99 Mdos/sgoc, Nellis Afb, NV 89191 | 2007-07-30 |
| 1619181302 | Ben Carter Robinson | Orthopaedic Surgery | 4700 N. Las Vegas Blvd, Nellis Afb-mofh Nellis Orthopedics, Las Vegas, NV 89191 | 2007-05-10 |
| 1609992205 | Conrad Lochner IIi, Odpc | Optometrist | 5691 Rickenbacker Road, Bldg. 431, Las Vegas, NV 89191 | 2007-03-22 |
| Find all providers in zip 89191 | ||||
| Taxonomy Code | 1223P0300X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Periodontics |
| That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588924294 | Blake Hoedebecke | Dentist | 4700 Las Vegas Blvd N, Nellis Afb, NV 89191 | 2012-05-29 |
| 1609097120 | Danny K. Wong | Dentist | 4700 Las Vegas Blvd N, Nellis Afb, NV 89191-6600 | 2007-05-01 |
| 1770544553 | Enrique E Rosado | Dentist | 4700 Las Vegas Blvd. Bldg. 1300, Nellis Afb, NV 89191 | 2006-03-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619302353 | Jessica Ann Silva | Dentist | 710 Coronado Center Dr, Suite 100, Henderson, NV 89052-4289 | 2013-09-12 |
| 1710259254 | James Rogers | Dentist | 3575 S Town Center Dr, Suite 110, Las Vegas, NV 89135-3045 | 2012-01-30 |
| 1760774558 | Benjamin Ellsworth | Dentist | 505 Bachelor Button St, Las Vegas, NV 89138-6077 | 2011-05-11 |
| 1043510399 | Aaron G Radmall | Dentist | 366 W Lake Mead Pkwy #100, Henderson, NV 89015 | 2010-11-02 |
| 1518285808 | Curry H. Leavitt | Dentist | 7475 W Sahara Ave, 101, Las Vegas, NV 89117-2867 | 2010-05-11 |
| 1588861348 | Eric Bernzweig | Dentist | 6835 W Charleston Blvd, Las Vegas, NV 89117 | 2007-06-27 |
| 1568674109 | John Frank Cercek Jr. | Dentist | 805 West 7th Street, #202, Reno, NV 89503-2795 | 2007-05-04 |
| 1790808004 | John Richard Kaminski | Dentist | 1155 W 4th St Ste 218, Reno, NV 89503-5149 | 2007-04-10 |
| 1861515819 | Michael Almaraz, D.d.s.,ltd | Dentist | 1675 Vista Ln, Carson City, NV 89703-4640 | 2007-04-06 |
| 1235269838 | Richard Alan Mecall | Dentist | 2327 Green Mountain Ct, Las Vegas, NV 89135-1536 | 2007-03-06 |
| Find all providers with the same taxonomy | ||||
| City | NELLIS AFB |
| Zip Code | 89191 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.