MEDICARE: JED HARRIS DMD

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	5749	WI

General Provider Information

NPI Number	:	1871881169
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JED HARRIS DMD

Provider Business Mailing Address
First Line	:	281 SANDERS CREEK PKWY
Second Line	:
City	:	EAST SYRACUSE
State	:	NY
Zip	:	13057-1307
Country	:	US
Telephone Number	:	315-454-6000
Fax Number	:

Provider Business Practice Location Address
First Line	:	834 W JOHNSON ST
Second Line	:
City	:	FOND DU LAC
State	:	WI
Zip	:	54935-2018
Country	:	US
Telephone Number	:	920-929-7400
Fax Number	:

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

Provider Enumeration Date	:	07/20/2011
Last Update Date	:	07/20/2011

Similar Medicare Providers

1790244481 — LATOYA BURNS
Practice Location Address:

2018 LAC LA BELLE DR
HARVEY, LA
70058-5235

Practice Phone: 504-473-8470
Practice Fax:

1184388878 — JONATHAN THOMAS
Practice Location Address:

727 W JOHNSON ST
FOND DU LAC, WI
54935-2015

Practice Phone: 920-581-0111
Practice Fax:

1164403226 — MICHAEL W JONES MD
Practice Location Address:

480 E DIVISION ST
FOND DU LAC, WI
54935-3734

Practice Phone: 920-926-4100
Practice Fax:

1144368341 — WISCONSIN VISION, LLC
Practice Location Address:

459 W JOHNSON ST
FOND DU LAC, WI
54935-3170

Practice Phone: 920-922-5990
Practice Fax: 920-922-7482

1144375825 — DR. STEVEN GREGORY MERESS MD
Practice Location Address:

180 KNIGHTS WAY
FOND DU LAC, WI
54935-8080

Practice Phone: 920-922-5433
Practice Fax: 920-273-0480

1528062452 — DR. KENNETH J SCHOLZ DDS
Practice Location Address:

355 N PETERS AVE
FOND DU LAC, WI
54935-8258

Practice Phone: 920-921-0440
Practice Fax: 920-921-0491

Directions to “ JED HARRIS DMD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.