DR. MARY THERESA HARRIS DDS
NPI 1417471327
Dentist in Crystal Lake, IL
About Dr. Mary Theresa Harris Dds NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. MARY THERESA HARRIS DDS (NPI 1417471327) is an individual dentist in Crystal Lake, Illinois, licensed in Illinois (019031314) and active in the NPI registry since August 2017. She has opted out of Medicare through July 20, 2027 and remains eligible to order and refer.
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Opted out of Medicare
Dr. Mary Theresa Harris Dds has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from July 20, 2023 through July 20, 2027.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 60014 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 5
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
CRYSTAL LAKE, IL 60014
CRYSTAL LAKE, IL 60014
CRYSTAL LAKE, IL 60014
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Mary Harris's NPI number?
The NPI number for Mary Harris is 1417471327. It was assigned to this individual provider in the NPPES registry on August 1, 2017.
Where is Mary Harris located?
Mary Harris practices at 1500 Carlemont Dr, Crystal Lake, IL 60014. The listed phone number is (815) 477-2273.
What is Mary Harris's specialty?
The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.
Is Mary Harris enrolled in Medicare?
No. Mary Harris has opted out of Medicare through July 20, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.
What insurance does Mary Harris accept?
Health plans from Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas list Mary Harris as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Mary Harris was last updated on December 28, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Dr. Mary Theresa Harris, DDS · NPI 1417471327
Dentist provider in Crystal Lake, Illinois. Individual provider, active in the CMS NPPES registry since August 1, 2017.
## Identity
- **NPI:** 1417471327 (Entity type: Individual)
- **Enumerated:** August 1, 2017
- **Primary specialty:** Dentist · taxonomy 122300000X
- **State license:** 019031314 (Illinois)
- **Sole proprietor:** No
## Practice location
- **Address:** 1500 CARLEMONT DR, Crystal Lake, IL 60014-1833
- **Phone:** (815) 477-2273
## Medicare
- **Medicare:** Opted out of Medicare (opt-out affidavit on file, in effect through July 20, 2027); services are provided under private contract
## Record status
- **NPPES last updated:** December 28, 2020
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Source: [NPI Profile](https://npiprofile.com/npi/1417471327) · Data from the CMS NPPES public registry.