Active NPI
Lawrence Steven Holtzman, D.M.D.
- Oral and Maxillofacial Surgery (Dentist)
- Bronx, NY
National Provider Identifier
1043396930
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)
- License
- 040711
- Practice address
- 1250 Waters PL Ste 503
Bronx, NY 10461-2732 - Phone
- (718) 824-4200
- Fax
- (718) 824-4201
- NPI assigned
- Oct 31, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 | 040711 | NY | Primary |
Addresses
Primary practice location
1250 Waters PL Ste 503
Bronx, NY 10461-2732
Mailing address
1250 Waters PL Ste 503
Bronx, NY 10461-2732
Phone (718) 824-4200
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 1, 2022 through Apr 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 040711 | NY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162252800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1227484800000",
"number": "1043396930",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1250 WATERS PL STE 503",
"city": "BRONX",
"state": "NY",
"postal_code": "104612732",
"telephone_number": "718-824-4200",
"fax_number": "718-824-4201"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1250 WATERS PL STE 503",
"city": "BRONX",
"state": "NY",
"postal_code": "104612732",
"telephone_number": "718-824-4200",
"fax_number": "718-824-4201"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLTZMAN",
"first_name": "LAWRENCE",
"middle_name": "STEVEN",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-31",
"last_updated": "2008-11-24",
"status": "A"
},
"taxonomies": [
{
"code": "1223S0112X",
"taxonomy_group": "",
"desc": "Dentist, Oral and Maxillofacial Surgery",
"state": "NY",
"license": "040711",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2008; 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.