Individual provider Active NPI

Ashley D. Hollowell, DDM

  • General Practice Dentistry
  • Canton, MS
National Provider Identifier
1083627509
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
319201 Issued in MS
Practice address
148 E Peace St
Canton, MS 39046-4520
Phone
(601) 859-2271
Fax
(601) 859-2271
NPI assigned
Aug 14, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 319201 MS Primary

Addresses

Primary practice location

148 E Peace St
Canton, MS 39046-4520

Mailing address

148 E Peace St
Canton, MS 39046-4520
Phone (601) 859-2271

Other identifiers 1

IdentifierTypeStateIssuer
00660438MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20160321000417 MS Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 7012214901

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
319201MSMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Ashley D. Hollowell, DMD Past Accepting new patients

Networks

  • LA PPO C-SNP

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": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083627509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "148 E PEACE ST",
            "city": "CANTON",
            "state": "MS",
            "postal_code": "390464520",
            "telephone_number": "601-859-2271",
            "fax_number": "601-859-2271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "148 E PEACE ST",
            "city": "CANTON",
            "state": "MS",
            "postal_code": "390464520",
            "telephone_number": "601-859-2271",
            "fax_number": "601-859-2271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLOWELL",
        "first_name": "ASHLEY",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "DDM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MS",
            "license": "319201",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00660438",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, MS

Sources for this page

Verify at the official NPI Registry.