Active NPI
Jaden Patrick Holton, DDS
- Oral and Maxillofacial Surgery (Dentist)
- Spencer, IA
National Provider Identifier
1023633351
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)
- License
- DDS-10326
- Practice address
- 820 Grand Ave
Spencer, IA 51301-3631 - Phone
- (712) 580-3038
- Fax
- (319) 774-8824
- NPI assigned
- Jun 12, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | DDS-10326 | IA | Primary |
Addresses
Primary practice location
820 Grand Ave
Spencer, IA 51301-3631
Mailing address
820 Grand Ave
Spencer, IA 51301-3631
Phone (712) 580-3038
Other practice location 1
819 Flindt Dr
Storm Lake, IA 50588-3206
Phone (712) 580-3038
Other practice location 2
3301 US 71
Spirit Lake, IA 51360-7605
Phone (712) 580-3038
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jul 1, 2026 through Jul 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RES-30596 | IA | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1591920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788307200000",
"number": "1023633351",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "820 GRAND AVE",
"city": "SPENCER",
"state": "IA",
"postal_code": "513013631",
"telephone_number": "712-580-3038",
"fax_number": "319-774-8824"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "820 GRAND AVE",
"city": "SPENCER",
"state": "IA",
"postal_code": "513013631",
"telephone_number": "712-580-3038",
"fax_number": "319-774-8824"
}
],
"practiceLocations": [
{
"address_1": "819 Flindt Dr",
"address_purpose": "LOCATION",
"city": "Storm Lake",
"state": "IA",
"postal_code": "505883206",
"country_code": "US",
"telephone_number": "712-580-3038",
"fax_number": "319-774-8824",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3301 US 71",
"address_purpose": "LOCATION",
"city": "Spirit Lake",
"state": "IA",
"postal_code": "513607605",
"country_code": "US",
"telephone_number": "712-580-3038",
"fax_number": "319-774-8824",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HOLTON",
"first_name": "JADEN",
"middle_name": "PATRICK",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-06-12",
"last_updated": "2026-09-02",
"certification_date": "2026-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "1223S0112X",
"taxonomy_group": "",
"desc": "Dentist, Oral and Maxillofacial Surgery",
"state": "IA",
"license": "DDS-10326",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Spencer, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.