Holly Tree Pediatric Dentistry

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

3427 Issued in SC

Legal business name

HOLLY TREE PEDIATRIC DENTISTRY

Practice address

1334 Highway 14
Simpsonville, SC 29681-5659

Phone

(864) 297-5585

Fax

(864) 297-4166

NPI assigned

Mar 19, 2015

Organization subpart

No

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

Authorized official

Name

Ann Bynum, DDS

Title

President

Phone

(864) 297-5585

Specialties & licenses 1

Addresses

Other names 1

• Holly Tree Pediatric Dentistry Doing business as

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

{
    "created_epoch": "1426723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709164800000",
    "number": "1083008890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1334 HIGHWAY 14",
            "city": "SIMPSONVILLE",
            "state": "SC",
            "postal_code": "296815659",
            "telephone_number": "864-297-5585",
            "fax_number": "864-297-4166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1334 HIGHWAY 14",
            "city": "SIMPSONVILLE",
            "state": "SC",
            "postal_code": "296815659",
            "telephone_number": "864-297-5585",
            "fax_number": "864-297-4166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLLY TREE PEDIATRIC DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-19",
        "last_updated": "2024-02-29",
        "certification_date": "2021-11-19",
        "status": "A",
        "authorized_official_last_name": "BYNUM",
        "authorized_official_first_name": "ANN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "864-297-5585",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "SC",
            "license": "3427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Holly Tree Pediatric Dentistry",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Holly Tree Pediatric Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Beth Hollenbeck, OTR
• Holley Endodontics, PA
• Gabriel Martin Holley, DDS, MS
• Holly Tree Family Dental, PA
• Holly Tree Family Practice
• Crystal Holmes
• Rebecca H Holmes, D.M.D.
• Shawander Holmes
• Jessica Lee Holsen, M.A., BCBA
• Samuel G Holtzclaw Jr., DMD

• Pediatric Dentistry in Simpsonville, SC
• Providers in Simpsonville, SC by specialty
• Pediatric Dentistry in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.