MEDICARE: DR. JEANA MARIE HARMON DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	38849	TX
2	1223G0001X	General Practice Dentistry	6893	LA
3	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	6893	LA
4	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	38849	TX

General Provider Information

NPI Number	:	1780179556
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEANA MARIE HARMON DDS

Provider Business Mailing Address
First Line	:	11102 HEARTLEAF ASTER WAY
Second Line	:
City	:	CYPRESS
State	:	TX
Zip	:	77433-4546
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	12589 WESTHEIMER RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77077-5807
Country	:	US
Telephone Number	:	713-325-5183
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/25/2018
Last Update Date	:	08/08/2023

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