DR. BRAD JASON HARRIS (NPI# 1124203286) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124203286 |
| Entity Type | Individual |
| Full Name | DR. BRAD JASON HARRIS |
| Credential | D.M.D |
| Practice Address |
55 Whitcher St Ne Suite 140 Marietta GA 30060-1155 |
| Mailing Address |
345 Parkway 575 Suite 203 Woodstock GA 30188-3897 |
| Practice Telephone | 7704227630 |
| Practice Fax Number | 7704226017 |
| Mailing Telephone | 7709244095 |
| Mailing Fax Number | 7709244096 |
| Enumeration Date | 2008-01-08 |
| Last Update Date | 2008-01-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 204E00000X | Oral & Maxillofacial Surgery | DN12915 | GA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730595224 | Brad Harris | Anesthesiology | 50 N Medical Dr, Salt Lake City, UT 84132 | 2014-07-07 |
| 1629393731 | Brad Wesley Harris | Counselor | 1020 Sw Taylor St, 448, Portland, OR 97205-2543 | 2010-03-31 |
| Street Address |
55 WHITCHER ST NE SUITE 140 |
| City | MARIETTA |
| State | GA |
| Zip Code | 30060-1155 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730183377 | Vijay Nath | Specialist | 55 Whitcher St Ne, Ste 460, Marietta, GA 30060-1171 | 2005-06-10 |
| 1710452875 | Jaleny Abajobir | Nurse Practitioner | 55 Whitcher St Ne, Marietta, GA 30060-1155 | 2018-10-04 |
| 1366961591 | Rachel Alexandra Strickland | Nurse Practitioner | 55 Whitcher St Ne, Marietta, GA 30060-1155 | 2017-09-19 |
| 1730609850 | Rudi Maria Coleman | Social Worker | 55 Whitcher St Ne, Marietta, GA 30060-1155 | 2017-06-20 |
| 1114451432 | Nerma S Mccrary | Nurse Practitioner | 55 Whitcher St Ne, Suite 460, Marietta, GA 30060-1155 | 2017-04-13 |
| 1215476304 | G | Nurse Practitioner | 55 Whitcher St Ne, Marietta, GA 30060-1155 | 2017-02-22 |
| 1972042117 | Joslyn Gross | Nurse Practitioner | 55 Whitcher St Ne, Ste 160, Marietta, GA 30060-1155 | 2017-02-21 |
| 1639616089 | Lonnie Jones | Nurse Practitioner | 55 Whitcher St Ne, Suite 130, Marietta, GA 30060-1155 | 2017-01-24 |
| 1073059804 | Melida Garcia | Nurse Practitioner | 55 Whitcher St Ne, Suite 350, Marietta, GA 30060-1155 | 2017-01-18 |
| 1528503166 | Helen W. James | Nurse Practitioner | 55 Whitcher St Ne, Suite 350, Marietta, GA 30060-1155 | 2017-01-05 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144845116 | Legacy Center for Spinal Surgery, LLC | Neurological Surgery | 1900 The Exchange, Ne, Suite 600, Marietta, GA 30060 | 2020-06-15 |
| 1407477193 | Michael Cynil Daniel | Counselor | 698 N Marietta, Pkwy, Marietta, GA 30060 | 2020-05-04 |
| 1285253401 | Cameron Thomas Kennelly | Student in an Organized Health Care Education/Training Program | 677 Church Street Ne Attn:gme, Marietta, GA 30060 | 2020-04-09 |
| 1922640739 | Jeremiah George Blair | Physician Assistant | 61 Whitcher St Suite 2100, Marietta, GA 30060 | 2019-10-14 |
| 1164064945 | Denise Alicia Mick | Registered Nurse | 677 Church St Wellstar Kennestone Hospital, Marietta, GA 30060 | 2019-10-12 |
| 1184283772 | Iora Health Georgia, P.C. | Internal Medicine | 280 Cobb Pkwy Se, Suite 60, Marietta, GA 30060 | 2019-06-07 |
| 1346703212 | Caitlin Virginia Mueller | Student in an Organized Health Care Education/Training Program | 677 Church Street Ne, Attn: Gme, Marietta, GA 30060 | 2019-04-08 |
| 1184187205 | Adero Francis | Student in an Organized Health Care Education/Training Program | Wellstar Kennestone Gme Internal Medicine Clinic, 833 Campbell Hill St Nw, Suite 250, Marietta, GA 30060 | 2019-04-08 |
| 1659832749 | Matthew Mozzo | Student in an Organized Health Care Education/Training Program | 677 Church Street / Lower Level, Gme Department / I.m., Marietta, GA 30060 | 2019-03-29 |
| 1245797430 | La'myia Spentz | Specialist | 109 Anderson St Ne, Suite 608, Marietta, GA 30060 | 2019-02-25 |
| Find all providers in zip 30060 | ||||
| Taxonomy Code | 204E00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Oral & Maxillofacial Surgery |
| Oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery. |
| Notes: Source: American College of Surgeons, 2013. www.facs.org [7/1/2013: definition added, source added, additional resources added] Additional Resources: American Board of Oral and Maxillofacial Surgery and American Association of Oral and Maxillofacial Surgeons While this is generally considered a specialty of dentistry, physicians can also be board certified as oral and maxillofacial surgeons through the American Board of Oral and Maxillofacial Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952363442 | Advanced Oral and Maxillofacial Surgery PC | Oral & Maxillofacial Surgery | 3535 Roswell Rd, Suite 27, Marietta, GA 30062-8826 | 2006-04-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124453337 | Ladi Doonquah | Oral & Maxillofacial Surgery | 3660 Flat Shoals Rd Ste 100, Decatur, GA 30034-1649 | 2013-09-06 |
| 1699040121 | Shenan Marie Bradshaw | Oral & Maxillofacial Surgery | 5505 Peachtree Dunwoody Rd Ste 660, Sandy Springs, GA 30342 | 2012-03-16 |
| 1720107105 | Christian Loetscher | Oral & Maxillofacial Surgery | 4205 N Point Pkwy Ste F, Alpharetta, GA 30022-8808 | 2007-03-28 |
| 1659460772 | William Jones Phillips | Oral & Maxillofacial Surgery | 698 Medical Park Lane, Gainesville, GA 30501 | 2006-10-12 |
| 1841306909 | Lawrence Matthew Marra | Oral & Maxillofacial Surgery | 3965 Holcomb Bridge Road, Suite 102, Norcross, GA 30092 | 2006-08-22 |
| 1861505141 | Durwood M Johnson Jr. | Oral & Maxillofacial Surgery | 1260 Hwy 54 W, Suite 200, Fayetteville, GA 30214 | 2006-08-17 |
| 1184667370 | Scott S Derossi | Oral & Maxillofacial Surgery | 1430 John Wesley Gilbert Drive, Gc-1024, Ghsu College of Dental Medicine, Augusta, GA 30912-1001 | 2006-06-14 |
| 1942258397 | Henry W Ferguson | Oral & Maxillofacial Surgery | 1430 John Wesely Gilbert Drive, Gc-1024, Augusta, GA 30912-1001 | 2006-05-05 |
| 1295791549 | Glenn Maron | Oral & Maxillofacial Surgery | 999 Peachtree St Ne, Ste 715, Atlanta, GA 30309 | 2006-04-25 |
| 1114425964 | Gofs Stockbridge | Oral & Maxillofacial Surgery | 225 Country Club Dr, #110, Stockbridge, GA 30281 | 2018-01-26 |
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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.