Individual provider Active NPI

Von Joseph Holbrook, D.D.S

  • Dentist
  • Ventura, CA
National Provider Identifier
1023205663
Registry record updated Sep 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
54713 Issued in CA
Practice address
88 N Oak St
Suite 2a
Ventura, CA 93001-5686
Phone
(805) 643-5026
Fax
(805) 643-5029
NPI assigned
Sep 27, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 54713 CA Primary

Addresses

Primary practice location

88 N Oak St
Suite 2a
Ventura, CA 93001-5686

Mailing address

88 N Oak St
Suite 2a
Ventura, CA 93001-5686
Phone (805) 643-5026

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150710002300 TX Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 5597077016

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
54713CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Johnson Family Dental Office Inc. Dentist Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1190851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190851200000",
    "number": "1023205663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "88 N OAK ST",
            "address_2": "SUITE 2A",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930015686",
            "telephone_number": "805-643-5026",
            "fax_number": "805-643-5029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "88 N OAK ST",
            "address_2": "SUITE 2A",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930015686",
            "telephone_number": "805-643-5026",
            "fax_number": "805-643-5029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLBROOK",
        "first_name": "VON",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-27",
        "last_updated": "2007-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "54713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ventura, CA

Sources for this page

Verify at the official NPI Registry.