Susan D. Jolliff, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

20448 Issued in TX

Practice address

702 W 17TH St
Brady, TX 76825-6936

Phone

(325) 597-7441

Fax

(325) 597-0380

NPI assigned

Jun 9, 2006

Last updated

Sep 3, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Apr 10, 2017 through Apr 10, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Brady Dental Group, PA

  • Durable Medical Equipment & Medical Supplies
  • Brady, TX
  • NPI 1831747799
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567468800000",
    "number": "1003857442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 W 17TH ST",
            "city": "BRADY",
            "state": "TX",
            "postal_code": "768256936",
            "telephone_number": "325-597-7441",
            "fax_number": "325-597-0380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 W 17TH ST",
            "city": "BRADY",
            "state": "TX",
            "postal_code": "768256936",
            "telephone_number": "325-597-7441",
            "fax_number": "325-597-0380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOLLIFF",
        "first_name": "SUSAN",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-09",
        "last_updated": "2019-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TX",
            "license": "20448",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "20448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sueellen Hernandez, LVN
• Kevin Daniel Hodnett, MD
• Jana Gay Holubec, MS, CCC/SLP
• Suzanne Holubec, LBSW,IPR
• Kimberly Regina Huseman, AGACNP-BC
• Alexandria Elaine Jordan, APRN, FNP-C
• Kevin Hodnett MD PLLC
• Marion Jo Kitsmiller, PA
• Ronald Dean Klein, D.D.S.
• Mary Lowe

• General Practice Dentistry in Brady, TX
• Providers in Brady, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.